CPR IN SCHOOLS
departments and parent-teacher associations) in
their effort to pass legislation. All told, 37 U.S.
states now require the training for high schoolers, with more on the way. (See Figure 1, p. 51.)
When it comes to cardiac arrest, seconds
count and bystanders need to act to save a life.
Investing in today’s students creates tomorrow’s lifesaving bystander rescuers and will save
countless lives. JEMS
Bentley J. Bobrow, MD, is distinguished professor of emergency medicine at the University of Arizona College of Medicine
and medical director for the Arizona Department of Health
Services Bureau of EMS and Trauma System He’s also a volunteer member of the American Heart Association’s Emergency
Cardiovascular Care Committee.
1. Benjamin EJ, Blaha MJ, Chiuve SE, et al. Heart disease and stroke
statistics—2017 update: A report from the American Heart
Association. Circulation. 2017;135( 10):e146–e603.
2. Kleinman ME, Brennan EE, Goldberger ZD, et al. Part 5: Adult
basic life support and cardiopulmonary resuscitation quality:
2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care.
Circulation. 2015;132( 18 Suppl 2):S414–S435.
3. Watanabe K, Lopez-Colon D, Shuster JJ, et al. Efficacy and retention of basic life support education including automated external
defibrillator usage during a physical education period. Prev Med
4. Beskind DL, Stolz U, Thiede R, et al. Viewing a brief chest-compression-only CPR video improves bystander CPR performance and responsiveness in high school students: A cluster
randomized trial. Resuscitation. 2016;104: 28–33.
Grassroots Effort in Arizona Pushes CPR
Training Over the Goal Line
The push to get CPR training to high schoolers in Arizona is a case study in how grassroots
activation can overcome resistance in order
to achieve an important public health victory.
Last year, the Grand Canyon state became the
32nd U.S. state required to offer CPR training to
high schoolers. The Arizona law directs that by
July 1, 2019, schools must “provide public school
pupils with one or more training sessions in cardiopulmonary resuscitation, through the use of
psychomotor skills in an age-appropriate manner, during high school.” 1
The goal of the Arizona legislation and similar
laws across the country is to combat a deadly cardiac arrest health crisis by transforming bystanders into rescuers.
The legislation signed by Arizona Gov. Doug
Ducey offers high school students at least one
CPR training session that includes in-person skills
practice. It can be taught at school or as a homework assignment outside of class.
“Training students in CPR means equipping
more people with the ability to act immediately, appropriately and potentially save a life
during an emergency,” said Annie Dockendorff,
a spokeswoman for the Arizona governor’s office.
In practical terms, the law will result in 60,000
high schoolers graduating annually with these
But the victory didn’t come easily. In fact, it
took several years to convince lawmakers and
school officials around the state that the training wouldn’t add to the responsibilities of already
overburdened teachers and administrators.
Paul Bourgeois, fire chief for the Superstition
Fire and Medical District, located on the east side
of the Phoenix Metro area in Pinal County, was
a core member of the team that rallied to press
state lawmakers. The team also included survivors saved by bystanders who performed CPR,
police officers and members of the American
“We did a legislative day where we had a game
plan to blitz the lawmakers down at the capital,” he said.
“I was able to share with lawmakers some real-life experiences of where we’ve revived people
successfully and saved lives. That was due in part
to the effort of well-trained bystanders on the
front end prior to our arrival. I think all that testimony together helped our cause,” Bourgeois said.
The other factor that helped push the law over
the goal line was that the proponents stressed the
simplicity—and minimal time commitment—of
learning CPR. This helped overcome resistance
from teachers worried about the burden.
“You can teach someone hands-only CPR in a
matter of about 30 seconds now,” Bourgeois said.
For states pushing similar laws for high schoolers, Bourgeois advises getting various teacher
groups on board early in the process. “The sooner
you can get a teacher association on board, the
more successful you’re going to be,” he said.
1. SB1137. Arizona Senate. Second regular session. 2016.
Retrieved Oct. 25, 2017, from http://apps.azleg.gov/
Grassroots efforts to press Arizona lawmakers to pass a bill requiring CPR education in high schools
were led by a core team that included Paul Bourgeois, fire chief for the Superstition Fire and Medical District, as well as survivors saved by bystander-assisted CPR, police officers and members of the
American Heart Association.
Students can quickly become proficient in CPR, even
with brief video-based and skills training.