Almost half the high schools in Toronto do not teach students how to perform cardio-pulmonary resuscitation (CPR), even though it's part of the Grade 9 curriculum and studies have shown it can greatly increase the survival rates of people who suffer heart attacks outside of hospitals.
Only 6 per cent of high schools schools train students to use an automatic external defibrillator (AED), which is found in less than half the schools, according to a survey by researchers at St. Michael's Hospital.
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 Dr. Laurie Morrison, who supervised the study. 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 Dr. Morrison, who heads Rescu, a research team dedicated to out-of-hospital resuscitation.
Dr. Morrison said 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 per cent of those cases and applied a defibrillator in nine per cent.
Research has shown that when defibrillators are publicly accessible and used by bystanders along with CPR, the odds of a patient surviving until they reach a hospital are doubled and may be as high as 75 per cent. 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 per cent for every minute that defibrillation is delayed.
The telephone survey of staff at 185 of Toronto's 271 high schools, conducted in the summer of 2009 found that 80 per cent of schools trained their staff to use CPR, but only 51 per cent trained students.
Dr. 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 both the course and supply teachers to replace them.
But Dr. 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."