High school students practiced hands-only cardiopulmonary resuscitation in downtown San Diego on Thursday, their efforts literally pushing toward the goal of training 1 million people across the county in lifesaving techniques that new findings from UC San Diego estimate could save nearly 500 local lives over five years.
Run by San Diego Project Heart Beat, the training session for 35 students at E3 High School is among many existing efforts countywide recently pulled together under the banner of Revive & Survive, a new collaborative effort to increase CPR training.
Working together, the county public safety group and Herbert Wertheim School of Public Health at UCSD launched the effort in February, using their combined clout to set a public goal of 1 million bystander CPR trainings and dubbing the effort Revive & Survive.
The idea, explained Cheryl Anderson, Wertheim’s dean, is to inspire the public to get so excited about meeting the goal that enrollment in CPR training programs increases rapidly. Already, she said, 25 organizations, including the local chapters of the Red Cross and American Heart Association, are participating.
“We really want to mobilize all bystander CPR training activities within the county such that their doors are being knocked on every single day by residents who want to be trained,” Anderson said.
Toward that end, Revive & Survive maintains a local list of training organizations available to conduct sessions on its website,revivesurvive.ucsd.edu.
The effort has moved the needle in its first three months, though there is a long way still to go to hit the 1 million mark.
“We’re now at 108,346, but who’s counting?” Anderson said Friday.
Adding a zero to that number will take a lot more work, and there are hopes to go to one of the biggest potential sources of new trainees this fall.
“We know that if we can mobilize K through 12 schools to train students, their parents and staff, that we would could touch 1.3 million people,” Anderson said. “If we are able to have that program up and going, that would be a huge lift.”
It may help if the public knew more precisely how much a significant investment in CPR training could help.
According to the American Heart Association, only about 40 percent of the estimated 350,000 cardiac arrests that occur outside hospitals each year receive immediate CPR from a bystander, leaving plenty of opportunity for improvement.
UCSD mathematical biologist Natasha Martin worked with a team at Wertheim to model the likely public health effects of training 1 million residents in CPR. The team looked at the county’s cardiac arrest registry to understand how many local residents typically suffer the condition outside hospitals every year.
They calculated that 8,445 cardiac arrests could be expected to occur outside hospitals between 2024 and 2029 across San Diego County and, with current rates of CPR training, 4,149 could be expected to have a CPR-trained bystander intervene. But if 1 million — nearly one-third of the local population — were trained, life-saving CPR could be expected to be delivered in 5,850 of those projected 8,445 cardiac arrests, a 41 percent jump that would lead to a significant gain in survival.
“We found that if we have this community-based training program and we look over five years, the model predicts that this community training could lead to over 1,700 more bystander CPR events administered to people who have cardiac arrest outside hospitals, and that increase could save the lives of 474 people,” Martin said.
Those numbers, Martin clarified, assume that the 1 million trainings had already occurred in 2024. However, she said that the effects should be the similar in any five-year period after the goal is reached.
Getting help quickly when the heart stops beating due to an electrical glitch called an arrhythmia is vital to survival. Research has found that every minute spent without a heartbeat increases the chances of brain injury and, after six minutes, death is highly likely.
But CPR keeps a person’s blood circulating, buying time for medical help such as a shock with an automatic defibrillator, which can act like a cardiac reset switch, restoring the proper rhythm.
Getting blood moving quickly not only decreases the chances of death, but also increases the odds of full recovery. The shorter time that brain cells go without oxygenated blood, the greater their likelihood of remaining functional.
The CPR model also looked at this factor.
“In addition to saved lives, we estimated that there are an additional 411 people who end up with good health outcomes,” Martin said.
How long it will take for Revive & Survive to hit its goal of 1 million people trained is unclear, though some have said they hope the milepost can be reached by the end of the year. Given that only one-tenth of that number has been reached so far, and 2024 is almost half over, reaching the finish line before New Year’s Day seems unlikely.
But Martin said there is no reason to expect that this movement will grow in a linear fashion. While she said she is unaware of research specifically on the rate of uptake of bystander CPR training, there is research into the uptake of new technologies and social norms in human populations that suggests the spread of information is often exponential.
“I would expect that, as we increase the number of people who are trained, we’ll see a rapid, potentially exponential increase, especially in the early stages as people hear about it from their family members and want to get trained,” Martin said.
And it doesn’t hurt that learning CPR is easier than it used to be.
Rescue breathing, the practice of pausing chest compressions to breathe into a person’s mouth, was eliminated from standard CPR training in 2008. Today, the focus is on making those chest compressions as perfect as possible, following a rhythm of 120 beats per minute, roughly the pace of the bass line in the 1970s Bee Gees hit Stayin’ Alive.
