After Noah Weeda collapsed during soccer drills in April 2015 at his Grand Rapids, Mich., high school, best friend Tyler Menhart called 911 and used CPR skills he learned as a Boy Scout.
In South Carolina, 18-year-old high school football player Ronald Rouse died in 2012 after collapsing twice during a home game. The cause of death was a heart condition.
Both experiences led to efforts to improve lifesaving education in both states. In fact, Michigan and South Carolina are among eight new states that have adopted high school curriculum or passed laws requiring CPR training to graduate starting in the 2017-2018 school year.
The other six states are Missouri, Nevada, New Mexico, Ohio, South Dakota and Wisconsin.
CPR — a technique that includes chest compressions with or without rescue breaths — should be performed when someone’s heart stops, known as cardiac arrest.
Cardiac arrest can be caused by a malfunction of the heart’s electrical system, a heart attack, drug overdose, drowning or other causes. The lack of oxygenated blood can cause brain damage or death in 10 minutes or less. CPR can keep blood flowing to the brain and other organs, doubling or tripling a person’s chance of survival.
Yet, less than half of the more than 350,000 Americans who experience cardiac arrests outside a hospital each year receive bystander CPR before medical help arrives. Only about one in 10 survives.
Advocates in states with new CPR in school laws hope to see higher survival rates.
“The more people who learn CPR, the better the chances are that a bystander will be ready, willing and able to act,” said Lt. Bryan Wonn, a professional standards investigator and CPR instructor for the Columbus, Ohio, Division of Fire. “By starting in school, you get access to a lot of people.”
In some states such as Ohio, the new law requires students to receive training in CPR and use of an automated external defibrillator, or AED, a portable device that can shock the heart back to a normal rhythm.
Overall, 37 states plus Washington, D.C., have laws requiring hands-on CPR education before high school graduation. Laws also have been passed in California, Maine and Montana, but they fall short of criteria set by the American Heart Association.
After existing legislation takes effect, 2.2 million public school students nationwide will be trained each year in CPR.
The impact can have a much further reach “when the child goes home and helps protect the community outside of school,” said Vinay Nadkarni, M.D., associate director of the Center for Resuscitation Science at the University of Pennsylvania School of Medicine. Seventy percent of out-of-hospital cardiac arrests happen at home.
Earlier this year, a woman holding a toddler rushed into a Tennessee fast-food joint where Kaela Eads, 18, was working. Her son wasn’t breathing, so Kaela began CPR, which she had learned in high school under the state’s 2012 law.
Similar lifesaving action by teenagers sparked legislation in some states with new CPR in school laws. In Michigan, students Noah and Tyler testified in support of the state bill.
“At the beginning, people were hesitant about putting a mandate on schools,” said Jason Trojan, an emergency medical technician for Emergent Health Partners in Ann Arbor, Mich. “Stories of real-life incidents helped.”
It remains to be seen how schools will react to the new law, but he noted that some schools allowed EMTs to offer CPR training in certain classes before the mandate.
Among the states that don’t require CPR training in school, some simply recommend training and several have introduced bills that failed.
Advocates would like to see all states pass CPR in school laws.
In Pennsylvania, where legislation is pending to require CPR training in schools, “some of the pushback to legislation has been the lack of funding,” said Nadkarni, who helped develop CPR courses for AHA. “Other impediments include concerns that achieving 100 percent compliance and the tracking of training can be burdensome.”