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Hanover High School Students Receive Hands-Only CPR Training

Hanover High School Students Receive Hands-Only CPR Training

I think when kids are taught CPR you strengthen health care in the community.

Candace Nattie, RN, Hanover High School nurse

To increase the number of community members who can administer cardiopulmonary resuscitation (CPR) if they witness a cardiac arrest, Matthew Braga, MD, and clinicians from Children’s Hospital at Dartmouth-Hitchcock (CHaD) and Dartmouth-Hitchcock Medical Center (DHMC) are teaming up with Hanover High School to teach students hands-only CPR and AED (automated external defibrillator) machine training. They launched the program in the spring of 2016, and plan to expand it to other area high schools in the coming year.

“One of the single most important factors that determines survival and whether a victim of a cardiac arrest will suffer brain damage depends on whether a bystander performs immediate high quality CPR while awaiting arrival of emergency medical services,” says Braga, the section chief of Pediatric Critical Care Medicine at CHaD.

As recommended by the American Heart Association (AHA), they teach students the hands-only CPR technique, which is for use on adults, children and infants (except newborns). This technique focuses on chest compressions for non-medically trained providers. “The AHA has recently stressed the importance of chest compression over ventilation (mouth-to-mouth breaths) for bystanders,” Braga says. “We want people to focus on performing high-quality chest compression, and to focus on pushing hard (2 to 2.4 inches), fast (at a rate of 100 to 120 per minute), allowing full recoil of the chest between compressions and avoiding interruptions when performing chest compressions.”

One of the instructors, Colin Treem, the life support program coordinator at DHMC’s Patient Safety Training Center, points out that certain songs are helpful for performing compression at the proper rate, as shown in this video. “‘Stayin’ Alive’ by the Bee Gees is the most commonly known one,” Treem says. “But ‘Star Wars’ fans can also use ‘The Imperial March’ (Darth Vader’s theme).”

The high school training program was spearheaded by a number of DHMC clinicians, according to cardiologist Alan Kono, MD, director of the Cardioavascular Critical Care Unit, whose wife Amy Kono is a math teacher at Hanover High School. “Dr. Mark Creager, director of the D-H Heart and Vascular Center, and at the time, president of the AHA [American Heart Association], and Edward Catherwood, D-H’s former section chief of Cardiology, asked me last year to connect with Hanover High School principal Justin Campbell to see if Hanover High would be interested in participating in and being the index pilot high school for a community program such as this, here in the Upper Valley, and also for entire the State of New Hampshire,” says Kono. Since Hanover High already owned eight mannequins, students would also be able to get extensive hands-on practice.

Campbell gave the greenlight and Braga’s team contacted Hanover High School nurse Candace Nattie, RN, who recruited Hanover High Health Educator Diane Guarino to work with the clinicians and incorporate the training into her class curriculum. The inaugural training was held last spring in Guarino’s sophomore health class, and another group of sophomores were trained in December 2016. The instructors have included Treem and his D-H Patient Safety Training Center colleague Mark Cookson, a simulation technical assistant, as well as Derek Callaway, PA, who works in the Pediatric Intensive Care Unit.

The CHaD and D-H volunteers spent an entire day at Hanover High, holding five hour-long training sessions with about 20 students in each session. “They trained half of the sophomore class in December,” says Guarino, who notes that about 200 students are being trained annually. “They were extremely professional and very well-received by the students. We’re working with Colin to schedule the next training session in the spring, which will probably be in May.”

The goal is to have every student trained in CPR by the time they graduate, says Nattie. “I think when kids are taught CPR you strengthen health care in the community, “ she says. “The kids are very enthusiastic about the subject and take it very seriously. It gives them a skillset they can use if they work as lifeguards and babysitters, and it makes them feel confident that they can take action if need be.”

“We’re teaching them to have an awareness about the environment they’re in, which includes knowing where is the closest AED is and how to access it,” Braga says. “If someone suffers a cardiac arrest, they’ll have the confidence to start doing chest compressions, call 911, and put the AED on and let it shock the patient if it’s needed. With this training you can overcome some of the hesitancies that people have when something like this happens. It’s obviously a rare event, but it happens several times a year in our local community and these students can really save lives.”

Treem and the other volunteers were delighted with the response they received at Hanover High. “The kids were really energized and thankful for the experience,” says Treem. “Kudos to Hanover High School and Candace and Diane for implementing this program. My hope is that it piques the students’ interest in taking additional classes and getting certified. The American Heart Association offers a course that is geared toward the general public, called Heartsaver CPR and AED.”

Braga and Treem are seeking funding to expand the program to other area high schools. “We need to purchase additional kits for CPR training, which include the mannequins, and are also hoping to cover the cost of using staff from D-H’s Patient Safety Training Center for two days a year at each school.”

“If one life is saved due to our educational outreach, that’s enough,” says Treem. “It’s great to be able to empower these kids to do something if they witness a cardiac arrest.”


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