How do you convince an entire high school student body to learn hands-only CPR? Let the students do the teaching.
That was the strategy juniors Nikki Vukich and Erin Coonan came up with to motivate 850 Episcopal School of Jacksonville schoolmates to participate in the life-saving training recently.
The daughter of UF Health Jacksonville Chief Medical Officer David Vukich, MD, Nikki was determined to get her school involved when she learned about UF’s initiative to train 80,000 people in what is also known as bystander CPR.
The goal was initiated by Joseph Sabato Jr., MD, a University of Florida College of Medicine –Jacksonville assistant professor of emergency medicine and director of field operations and disaster management.
Sabato said lack of CPR training is a national problem. Only 25 percent of people who suffer cardiac arrest receive CPR before emergency crews arrive. The 75 percent who don’t have very little chance of survival. So Sabato came up with a plan to train enough people to fill EverBank Field. Sabato and Cynthia Gerdik, RN, UF Health Jacksonville’s director of critical care, are working with a core group of UF volunteers to teach CPR all over the First Coast, intent to reverse the trend locally.
Every year, roughly 1,000 people go into cardiac arrest on the First Coast, and only about 5 percent survive. Survival rates could increase to 15 to 20 percent with the help of the CPR initiative. Other areas that made a major push for training – including the Seattle area and the state of Arizona – saw changes of that magnitude.
The Take Heart First Coast initiative, headed by UF Health and the First Coast EMS Advisory Council, has reached 14,000 people so far, and that number is about to increase.
Duval County Public Schools is working with the group to train teachers, who will then train all students in the district's middle schools. The high schools also have a CPR training program underway.
The Nassau County Health Department is working with the county school district to train students. Inspired by Sabato's goal to fill EverBank Field with trainees, the health department wants to train enough people to fill each of the county's high school stadiums.
The University of North Florida also worked with Sabato and his team to train its entire student body. It started with 40 UNF interns who were working at UF Health, and then they taught their peers at UNF. Now Take Heart First Coast is included in freshman orientation, so incoming students receive the training each year.
Volunteers regularly appear at local running events, such as the Gate River Run, to offer training, thanks to a partnership with 1st Place Sports.
Sabato is discussing partnerships with other groups in the community.
In the past, CPR involved alternating between pumping on the victim’s chest and giving the person mouth-to-mouth resuscitation. But researchers found hands-only CPR, which eliminates mouth-to-mouth, is more successful in those first critical minutes after someone goes into cardiac arrest. Since the body already has a supply of oxygen that will last about six minutes, the idea is to offer continuous assistance in pumping the heart rather than interrupting pumping it for mouth-to-mouth.
At Episcopal School of Jacksonville, 35 students signed up to come to school on a Saturday to learn CPR – and how to teach it to others – with instructors from UF. Then on the schoolwide training day, those volunteers took over teaching in all of the high school’s science classes. They lectured, showed videos and slides, and then broke the classes into groups to practice on dummies.
“When someone goes into cardiac arrest, the heart suddenly stops working. It only takes six minutes before that causes damage to your brain and body,” junior Hodson Wood told classmates during one of the sessions. “That’s why CPR is so important. So you can buy more time while you wait for EMS to arrive.”
Another student, junior Michael Himebauch, assured the class the hands-only method is less intimidating than the previous way CPR was taught.
“With rescue breathing, you might be afraid of catching a disease or something or think it’s gross,” he said. “Now it’s just three steps. Check if the person is unresponsive, call 911, and then start compressions in the center of the chest.”
He advised compressing to the beat of the Bee Gees song “Stayin’ Alive” or using a phone app called CPR Tempo to meet the ideal range of 100 beats per minute (BPM). He told the students to put their phones on speaker so they could begin CPR during their 911 call if they don’t have anyone to assist them.
In another classroom, sophomore Kieran Wallace stressed that CPR requires strength, because the chest should be pressed down about 2 inches during each compression.
“You could break or crack the person’s ribs, but don’t stop. That means you’re doing it right,” he said.
Sabato and emergency medicine resident Trevor Smith, MD, sat in on some of the classes and shared some additional tips:
Interlock your hands, placing one on top of the other, lock your elbows, and then compress with the weight of your body instead of just your arms. Always press straight up and down rather than at an angle.
Always keep your hands in contact with the body during CPR, but allow the body to come all the way up before compressing again in order to allow the heart to refill with blood. This is also why it’s important to pump the heart rapidly, but not faster than the recommended 100 BPM.
Although it’s usually best to bypass rescue breathing, it’s important to still use it in the case of children in cardiac arrest, drownings, strangulations or prolonged CPR (more than 6 minutes), because in each of those cases the victims are typically lacking the oxygen they need.
If at all possible, have at least one other person ready to take over when your arms become tired. Administering CPR can be exhausting, even for professional athletes. If you’re alone and feel exhausted, take a break for about 10 seconds and then resume CPR.
Don’t worry about checking the patient’s pulse. “Even as physicians, we can have arguments about whether there’s a pulse or not,” Sabato said. “It’s more important to begin CPR than to take the time to look for a pulse.”
Don’t let fear stop you. It’s unlikely that you will seriously injure the person, and there is no law requiring you to be certified in order to help. The Good Samaritan law protects people who try to help.