Almost half the high schools in Toronto do not teach students how to perform cardiopulmonary resuscitation (CPR), even though it's part of the Grade 9 curriculum, according to a study conducted by Rescu, a Canadian research program that is part of the Rescue Outcomes Consortium, a large, multinational research collaboration of 10 sites across the U.S. and Canada.
There were 135 cardiac arrests in Greater Toronto Area schools from 2007 to 2009, one-third of them in people under 18. Bystanders performed CPR in 36 percent of those cases and applied a defibrillator in nine percent, according to Laurie Morrison, MD, director of Rescu and lead investigator for the study.
According to a different survey by researchers at St. Michael's Hospital in Toronto, only 6 percent of high schools train students to use automated external defibrillators (AEDs), which are found in less than half the schools,
Research has shown that when defibrillators are publicly accessible and used by bystanders along with CPR, the odds of a patient surviving until he or she reaches a hospital are doubled and may be as high as 75 percent.
The time that elapses between a heart attack and the start of defibrillation is the single greatest factor determining whether a patient survives. Survival rates drop by seven to 10 percent for every minute that defibrillation is delayed.
"If people don't learn how to perform CPR when they are in school, they may be uncomfortable as adults getting down on their knees and starting chest compressions when a stranger suffers a heart attack," said Morrison. Toronto has one of the lowest rates of bystanders helping others in the developed world.
"Like recycling, CPR training has to begin in school if we hope to transform the community into action," said Morrison, who heads Rescu.
Morrison and colleagues conducted a telephone survey of staff at 185 of Toronto's 271 high schools in the summer of 2009. They found that 80 percent of schools trained their staff to use CPR, but only 51 percent trained students.
Morrison said the low rate may reflect the fact that students need four hours of instruction to be certified in CPR and teachers have to take an annual three-day course to keep up their certification. Schools must pay for the course.
But Morrison said scientific studies show students don't have to be certified in CPR to save lives.
"You want people to respond to someone when they go down and start chest compressions and you can learn that in 22 minutes," she said. "You also want them to have the courage to reach up and grab the AED off the wall."