Mandating CPR Training

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MANDATING CPR TRAINING 8

Mandating CPR Training

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Herzing University

Mandating CPR Training

In 2013 there were 325,257 out-of-hospital cardiac arrest deaths in the United States (Go, et al., 2012, p. e 169). Many of these deaths could have been prevented if someone close by knew what to do to help save these people. In order to preserve life we must implement a mandated Cardio Pulmonary Resuscitation (CPR) and Automated External Defibrillator (AED) education for all able body adults who possess a driver’s license so we may increase the chances of survival for out-of-hospital cardiac arrest.

The out-of-hospital cardiac arrest survival rate for adults is 9.5% (Go, et al., 2012, p. e169). The heart going into a lethal rhythm Ventricular Fibrillation (v-fib) or Ventricular Tachycardia (VT) is when the ventricles of the heart just quiver and cannot pump blood, which causes sudden cardiac arrest. Of all the out-of-hospitals cardiac arrests 40.1% had bystander CPR initiated (Go, et al., 2012, p. e169). In-hospital cardiac arrest the survival rates jump to 23.9% (Go, et al., 2012, p. e221). This can be attributed to all hospital personnel having taken CPR and continued with biannual re-education. In other words, CPR saves lives.

CPR Needs and Education

With the current out-of-hospital survival rates being so low, there needs to be a mandated CPR education program that is linked to a driver’s license. The American Heart Association has a Family and Friends CPR course that teaches CPR and AED use on adults and children. The public could take this course ata local hospital, fire station, and police station or the public could hire a private instructor to come out to their homes for instruction. This needs to be coupled with a biannual refresher course to keep skills sharp(American Heart Association, n.d). If more people were required to know CPR, many lives would be saved.

In Denmark,authorities have rolled out an education program for the country’s children in which they teach CPR and allow the children to take the course material home to show their family and friends to teach them how to perform CPR hands only (Laerdal, n.d. para. 4). Denmark has also moved to make CPR education mandatory to receive a driver’s license (Rice, 2013, para. 2). Mandating that new drivers be require to obtain CPR training would be a good starting point here in the United States because Denmark has seen positive results from their increased CRP certification.

Denmark’s initiative to increase CPR education was started in 2005 and resulted inan increase of bystander CPR from 21.1% to 44.9% in only 5 years (Journal of the American Medical Association, 2013, para. 5). From 2001 to 2010, Denmark also saw a 13.9% increase in hospital survival (Journal of the American Medical Association, 2013, para. 6). This increased cardiac arrest survival rate of in-hospital survivalcould be attributed to an increase of bystander CPR on out-of-hospital cardiac arrest patients if victims of cardiac arrest received care before admission to the hospital.Denmark’s one-year survival rate after out-of-hospital cardiac arrest prior to their CPR education program was 2.9%, but after the CPR education initiative, their one-year survival rate went up to 10.2% (Journal of the American Medical Association, 2013, para. 6). During the 9-year study in Denmark, AED use on out of hospital cardiac arrest victims rose from 1.1% to 2.2% (Journal of the American Medical Association, 2013, para. 5).If the United States were to implement a similar program such as Denmark’s, the United States should expect to see a similar rise in cardiac arrest survival rates.

The idea of mandated CPR training is controversial, but public will can be swayed toward the cause by several incentives. To encourage people to act and help their fellow man, the government should create a positive reinforcement strategy. For example, for rendering aid, a police officer will issue a coupon for a discount on a citizen’s vehicle registration cost and put his or her name on a Good Samaritan web site. There could be a law put into place that if a person stops and renders aid, that his or her employer cannot take disciplinary action towards the Good Samaritan who was late to work.

AED Statistics and Deployment

The use of an AED coupled with the implementation of CPR is an essential part of cardiacresuscitation, and mandating AED training along with CRP training as well as increasing the number of available defibrillators would save lives.About 40% of out-of-hospital cardiacarrest is caused by the victims going into VT or V-fib (American Heart Association, 2008, pp. IV-19). The American Heart Association recommends AED deployment as soon as it can be confirmed that a victim is unresponsive (American Heart Association, 2011, p. 51). The quicker an AED can be deployed, the greater chance of survival for the victim.For every one minute that a victim goes without being defibrillated and without CPR, their chance of survival decreases 7% to10%, while CPR being performed will bring that rate down to 3% to 4% (American Heart Association, 2008, pp. IV-19). With an AED not immediately available, CPR alone has been shown to improve of the chance of survival rate, but not as much. There isa need for deployment and use of an AED as soon as possible when a person collapses to improve chance of survival even more.

The general public needs more awareness and AED training, andthere needs to be an increase in AED availability. The best chance of survival is when an AEDis deployed and delivers a shock in the first 3-5 minutes of cardiac arrest(American Heart Association, 2008, pp. IV-27). To meet that time range, there must be an ease of accessto these vital machines. Some states have already enacted some AED requirements. Rhode Islandand District of Columbia require health clubs to have at least one AED on site (National Conference of State Legislatures, 2013).However, the majority of states have not enacted such laws. In addition to required AED education, we must create a program that will encourage the general public to purchase and maintain AEDs. Local governments and healthcare institutions can help increase the number of AEDs available. Every town would benefit from creating a list of people who are willing to purchase an AED,and then the town can get a bulk discount from an AED manufacturer. In addition to the discounted price, as long as the owner keeps the AED in their vehicle and in operational condition in accordance with manufacturer guidelines, the town could provide the owner with a tax break. Additional incentives could further encourage people to have and use AEDs. For example, if an AED is deployed to help a cardiac arrest victim, the owner of the AED could be given a voucher for a gift card and have the AED supplies replaced free of charge. By mandating AED training when a citizen receives a driver’s license and providing incentives to increase AED availability, death rates from cardiac arrest would significantly decrease.

Resistance to Mandatory CPR Training

Some people may say that you cannot force them to get CPR training to get their driver’s license. They may say it violates their constitutional right as an American citizen. Yet,nowhere in the bill of rights or constitution does it guarantee you the right to drive. According to the California Department of Motor Vehicles website, “Having a driver’s license is a privilege, not a right” (Driving Responsibilities, n.d, p. 1).

People may also worry that they will be sued for providing aid to others. For example, there was a lawsuit in California involving a Good Samaritan. In this case, a passenger in a car was worried because the car was filled with smoke and that the car might be one fire, so she pulled her friend out of the car and in doing so paralyzed her. The Good Samaritan in this case was sued and not covered by the Good Samaritan laws in California (Donaldson James, 2008). However, the Good Samaritan in this casehad drugs and alcohol in her system, and would otherwise likely have been exonerated(Bennett, 2009, para. 6). Under current laws, a Good Samaritan that renders aid while sober will not be held accountable for any injuries that may come to the victim.

Conclusion

For the preservation of human life, we must as a society come together and mandate CPR training for the masses and a greater availability of AED to the general public. The current survival for out-of-hospital cardiac arrest rates leaves us with plenty of room for improvement. If we look to Denmark as starting point, we can save many more lives and improve on their already impressive success. We must not be stagnant in trying to improve our community. The next life that might be saved could be your own.

References

American Heart Association. (2011). Advanced cardiovascular life support: Provider manual. Dallas, Texas: American Heart Association. American Heart Association. (2008, November 8). Circulation AHA. Retrieved from http://circ.ahajournals.org/content/112/24_suppl/IV-19.full.pdf+html American Heart Association. (n.d). CPR learn more. Retrieved from www.heart.org/HEARTORG/CPRAndECC/HandsOnlyCPR/LearnMore/Learn-More_UCM_440810_FAQ.jsp Bennett, L. (2009, January). Good samaritan immunity limited to medical assistance. Retrieved from www.emsworld.com/article/10320650/good-samaritan-immunity-limited-to-medical-assistance California Department of Motor Vehicle. (n.d). Driving responsibilities. Retrieved from www.dmv.ca.gov/pubs/curriculum/Unit%201.pdf Donaldson James, S. (2008, December 19). Woman sued for rescue effort in car crash. Retrieved from ABC News: http://abcnews.go.com/TheLaw/story?id=6498405&page=1 Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Borden, W. B., et al. (2012, December 12). Heart disease and stroke statistics- 2013 update: A report from the American Heart Association. Retrieved from American Heart Association: http://circ.ahajournals.org/content/early/2012/12/12/CIR.0b013e31828124ad.full.pdf Journal of the american medical association. (2013, October 1). For the media. Retrieved from media.jamanetwork.com/news-item/study-finds-increase-survival-following-bystander-cpr-hospital-cardiac-arrest/ Laerdal. (n.d). Disseminating CPR training in the population. Retrieved from www.laerdal.com/us/UserStories/43258467/Disseminating-CPR-training-in-the-population National Conference of State Legislatures. (2013, January). State laws on cardiac arrest & defibrillators. Retrieved from National Conference of State Legislatures: http://www.ncsl.org/research/health/laws-on-cardiac-arrest-and-defibrillators-aeds.aspx Rice, K. (2013, October 4). Denmark’s CPR Success Story. Retrieved from Health and Safety Institute: http://www.hsi.com/Blog/bid/102360/Denmark-s-CPR-Success-Story