Learning to save lives can start as early as age 4, according to new scientific statement

Statement Highlights:

• School-aged children are highly motivated to learn basic life-saving skills, such as recognizing a cardiac arrest, calling for help and performing cardiopulmonary resuscitation (CPR), according to a new scientific statement from the International Liaison Committee on Resuscitation (ILCOR), the American Heart Association and the European Resuscitation Council.
• The statement identifies age-appropriate best practices to help children learn various skills that are part of the cardiac arrest chain of survival.
• Teaching children about CPR at regular intervals as they age will develop their skills and knowledge. For example, a 4-year-old who can identify when to call an emergency telephone number (911) becomes a 10-year-old who may begin to perform effective chest compressions.

Newswise — DALLAS, May 17, 2023 — A new scientific statement from ILCOR, the American Heart Association, and the European Resuscitation Council highlights that the training for cardiopulmonary resuscitation (CPR) can start as early as the age of 4. As children grow older, their CPR skills can progress, and by the age of 10, they may be capable of performing effective chest compressions on training manikins. The statement emphasizes the importance of early CPR training and suggests a layered approach to skill development as children advance in age. The findings were published in the peer-reviewed journal Circulation, which is the flagship journal of the American Heart Association.

The writing group of resuscitation scientists conducted a comprehensive review of over 100 research articles on training students in CPR. The findings of the review indicated that school-aged children show a high level of motivation to learn life-saving skills like CPR. Moreover, they often extend the impact of their training by sharing their knowledge with others, effectively multiplying the reach of CPR education. This highlights the potential of empowering children with CPR training to create a cascading effect in disseminating life-saving skills within their communities.

Bernd W. Böttiger, the chair of the statement writing group and an esteemed medical professional, emphasized the importance of training students in CPR to improve the response to cardiac arrest incidents outside of a hospital. He highlighted the potential impact of such training in increasing CPR rates and enhancing survival rates globally. The purpose of the research review is to inspire healthcare professionals, policymakers, local school authorities, and the general public to take proactive measures during cardiac emergencies. The goal is to encourage widespread action and preparedness to effectively respond to cardiac arrest situations whenever they occur.

Comilla Sasson, a member of the statement writing committee and an experienced emergency medicine physician, emphasized the importance of educating all family members on responding to cardiac arrest, considering that most incidents occur at home. Dr. Sasson highlighted the value of starting CPR training at a young age and reinforcing these skills consistently throughout a student's school years. This approach has the potential to educate multiple generations on how to respond to cardiac arrest situations, including performing chest compressions, rescue breaths, and utilizing automated external defibrillators (AEDs). By doing so, the aim is to increase the chances of survival in cardiac arrest cases.

Cardiac arrest outside of a hospital setting is a leading cause of death worldwide . Survival rates range between 2% and 20% globally and are particularly low without immediate recognition and action from a bystander .

The statement highlights that even if young children are not physically capable of performing effective chest compressions, they can still learn the fundamental steps and rhythm of CPR as well as gain knowledge about AEDs. While their physical abilities may be limited, the educational aspect is crucial. It has been observed through research that when school-aged children learn CPR, they have a significant impact on enhancing community preparedness. They often share their knowledge with family, friends, and neighbors, thereby extending the reach of CPR education and potentially increasing the number of individuals who are prepared to respond to cardiac emergencies.

In addition to what may be done in schools, families should have a cardiac emergency response plan in place. Make a plan within the household, and practice regularly by delegating the steps below :

1. Who will call 911? Use a cell phone. Put the phone on speaker while talking with the emergency dispatcher and starting CPR.
2. Who will start CPR? Double or triple the chance of survival by performing Hands-Only CPR immediately.
3. Who will open the door? Make sure your entrance is unlocked, giving first responders easy access to your residence.

The scientific statement on CPR training for students was created by a writing group consisting of volunteers from the International Liaison Committee on Resuscitation (ILCOR). This committee includes organizations such as the American Heart Association and the European Resuscitation Council. Scientific statements serve to increase awareness about cardiovascular diseases and stroke and aid in making well-informed healthcare decisions. They provide an overview of the current knowledge on a specific topic and identify areas that require further research. It's important to note that while scientific statements contribute to guideline development, they do not provide treatment recommendations. The official clinical practice recommendations of the American Heart Association are outlined in their guidelines.

All writing group members of this statement had expertise in the field of schoolchildren learning CPR. Co-authors are Daniel C. Schroeder, M.D., first author; Vice Chair Federico Semeraro, M.D.; Robert Greif, M.D., M.M.E.; Janet Bray, R.N., Ph.D.; Peter Morley, M.B.B.S., FAHA; Michael Parr, M.B.B.S.; Naomi Kondo Nakagawa, P.T., M.Sc., Ph.D.; Taku Iwami, M.D., Ph.D.; Simon-Richard Finke, M.D.; Carolina Malta Hansen, M.D., Ph.D.; Andrew Lockey, M.B., Ch.B., Ph.D.; Marina del Rios, M.D., M.Sc.; Farhan Bhanji, M.D., M.Sc. (Ed.); Comilla Sasson, M.D., Ph.D., FAHA; Stephen M. Schexnayder, M.D.; Tommaso Scquizzato; and Wolfgang A. Wetsch, M.D. Authors’ disclosures are listed in the manuscript. 

Additional Resources:

• Multimedia is available on the right column of the release link: https://newsroom.heart.org/news/learning-to-save-lives-can-start-as-early-as-age-4-according-to-new-scientific-statement?preview=5334579b5a57b66fc726c0cdbed616ce
• Spanish news release (to be added)
• After May 17, view the manuscript online.
• Chain of Survival graphic
• What is CPR?
• CPR in Schools
• Be the Beat
• Next Generation of Heartsavers
• VIDEO: Hands-Only CPR

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

###