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Lessons to take to heart

New program would make CPR and other emergency techniques a course of study in Pennsylvania schools

Tuesday, March 19, 2002

By Anita Srikameswaran, Post-Gazette Staff Writer

In Carol Spizzirri's opinion, people should learn to use first-aid skills as reflexively as they brush their teeth. If they did, her daughter might be alive today.

Online Graphic:
How to perform CPR



In the aftermath of her personal tragedy, Spizzirri of Chicago has helped make training in basic first aid and cardiopulmonary resuscitation, or CPR, a part of the curriculum from kindergarten to senior year in many Illinois schools.

Students in some Allegheny County schools soon may be learning those life-saving lessons, too, thanks to a pilot program modeled on the Illinois experience.

Spizzirri's mission began on Labor Day 1992 when her 18-year-old daughter, Christina, was hit by a car. Blood gushed from the severed main artery of the young woman's left arm. Direct pressure on the wound could have slowed the bleeding, but it took 13 minutes for ambulance personnel to get to the accident scene.

"The bystanders and the first responders -- police officers -- weren't equipped with [first aid] skills and so my daughter bled to death before EMS got there," said Spizzirri.

The grieving mother, who is a nurse, confronted state legislators about the lack of emergency medical training among police officers and other public servants in Illinois. The training has been required for firefighters and police in Pennsylvania for many years.

A year later, after Spizzirri had pounded the pavement of Washington D.C. to help get the money for it, a law was passed that students in Illinois' police and fire fighting academies had to be schooled in first aid and CPR.

"We had to change the mindset of people" who thought that providing care was someone else's job, she said. "Fortunately, several fire and police unions stood behind me. They knew many of their own people who either were shot or had heart attacks, and they needed to be trained in order to save their coworkers."

Her efforts caught the attention of Dr. Peter Safar, a founding father of CPR and a distinguished service professor at the University of Pittsburgh's Safar Center for Resuscitation Research. He met Spizzirri in Chicago and encouraged her to do more.

"I listened and have been trying very diligently to follow his big footsteps," she said. "He is my mentor."

Both Safar and Dr. Henry Heimlich are on the medical advisory board of Save A Life Foundation in the Chicago area, of which Spizzirri is founder and president.

In 1994, the foundation developed a pilot program in which EMS professionals taught 25,000 Illinois children basic life-saving skills in school.

Now, they reach almost 400,000 children. The Heartsaver CPR in Schools program has been made part of the curriculum for 730 public schools in Chicago and many others throughout Illinois.

Repetition is key

To make life-saving skills part of the children's body of knowledge, the lessons are repeated and built upon throughout the school years, from a half-hour session in kindergarten to an hour in elementary school and up to two hours in high school.

The youngest are taught who emergency personnel are, how and when to call for help, and how to stop bleeding with direct pressure. Slightly older children can be taught the Heimlich maneuver to assist choking victims. Techniques of CPR may be introduced around sixth grade.

Students are also taught to use precautions to reduce the risk of catching blood-borne infections such as HIV and hepatitis. In an emergency, for example, they may have to substitute plastic bags for latex gloves.

The foundation tests the children's knowledge immediately after the sessions and again three months later and has found that the students retained 97 percent of what they learned after three months.

And it saw "a 57 percent increase in willingness by these trained children to help another in need," Spizzirri said. "We are changing their attitudes."

According to Tammy Janney, an emergency medical technician for Guardian Angel Ambulance Service in West Homestead who is coordinating the launch of the foundation's program in Western Pennsylvania, bystanders often don't lend a hand in emergencies because they're afraid they'll make the victim worse.

"I explain to my students that somebody who does not have a pulse and is not breathing, for all intents and purposes, is dead. And you can't hurt them any more that that," Janney said. "You can only help them from that point on."


Another step in Pennsylvania

Automated external defibrillators are available free and at a discount for Pennsylvania school districts. Post-Gazette Education Writer Jane Elizabeth has the story.


People may also fear being sued. But like other states, Pennsylvania has a Good Samaritan law to protect from lawsuits those who try to help others during an emergency.

Janney said children are told it isn't possible to save everyone. But knowing that they tried to help may be comforting in the aftermath of a medical emergency.

Local government and school officials have been very receptive to the idea of getting the program into the curriculum, Janney said.

Many schools have run programs for their students, but not all teach first aid skills, such as bleeding control, as well as CPR. And they may only be taught to one or two grades, not all students.

Enhancing, not replacing

The new initiative would not replace successful problems in place, but would work in partnership, Janney said. "We have a common goal."

The American Heart Association has CPR programs integrated into the curriculums of ninth or tenth grade of some schools in Allegheny and other counties, said Kate Hodgdon, a community program director for the association's Operation Heartbeat.

In it, "the teachers become instructors," she explained. "They teach the students CPR and some of their students become instructors."

Janney said this information could then be passed on to students' parents through family discussions or educational material brought home.

Better yet would be automated interactive mannequins in self-training labs in public places, such as libraries, where people can learn at their own pace and convenience.

And the more people who have the skills, the better.

"It saves lives. It's as simple as that," said Dr. Bob Hickey, an emergency medicine expert at Children's Hospital who sits on Heart Association committees. "There have been plenty of studies that show cities that have higher rates of bystanders performing CPR have higher survival rates after cardiac arrest."

Janney's son showed her what a child can pick up from occasional exposure to first aid information. He once asked her why Spizzirri started the foundation, and she told him about Christina Spizzirri's death by bleeding.

The shocked 9-year-old responded: But Mommy, why didn't someone use direct pressure?

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