CPR in Schools

CPR in schools: school pupil with manikin

At RCUK, we believe that everyone should learn the skills to save a life. Schools offer a great environment for young people to learn and we have created a lesson plan to help you teach your students with confidence.

Skills in cardiopulmonary resuscitation (CPR) and the use of an automated external defibrillator (AED) are truly skills for life - and educating and empowering young people is one of the most important actions when it comes to improving survival of out of hospital cardiac arrests. 

In countries where basic life support is taught in schools, survival rates from sudden cardiac arrest are significantly (two to three times) higher than those where they aren’t taught. With 80% of cardiac arrests occurring in the home in the UK, your students could be the difference between life and death for someone they care about. 

We have created resources that will help teachers to deliver CPR education confidently to their students wherever they live in the UK at any time during the school year. If you’re looking for a suitable moment, Restart a Heart Day takes place every year on 16 October.

  • In England, teaching cardiopulmonary resuscitation (CPR) is part of the Health Education curriculum for secondary school students and is recommended for students aged 12+. It states that pupils should know life-saving skills, including how to administer CPR and the purpose of defibrillators and when one might be needed.
  • Every local authority in Scotland has committed to teach CPR to their secondary school pupils.
  • At key stages 3 and 4 for the Northern Ireland Curriculum the links with the concept of personal health are strong: “develop preventative strategies in relation to accidents in the home, school and on the road, for example knowing what to do in the event of cuts, burns, fire and emergency first aid etc.”
  • RCUK recommends that all students across the UK should be taught CPR and awareness of Automated External Defibrillators (AEDs).

Here’s how you can give pupils the skills to try to save a life if they witness someone collapse and stop breathing normally: 

 

RCUK CPR Lesson Plan for Secondary School Pupils 

A lesson plan for teachers which covers in person and online options for how to teach crucial skills.  

Lifesaver

A free digital game-in-a-film which puts young people at the heart of the action as they make the decisions and learn the skills needed to save a life. 

Sudden Cardiac Arrest Animation

A short animation to demonstrate how to minimise risk while doing CPR during a period of increased risk of infection, such as during COVID-19. 

Video: Sam's story

A real-life story of why CPR knowledge in the classroom was the difference between life and death for secondary student Sam.  

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We have also created template letters you can send to students’ parents / guardians in advance of you teaching this sensitive subject. All you need to do is tailor the template for the lesson option you will be using. A Basic Life Support Skills Checklist can also be used to support evaluation of student learning. 

These frequently asked questions have been developed to help teachers answer questions you may be asked by students when teaching CPR. We recommend you have these to hand during the lesson. 

CPR stands for cardiopulmonary resuscitation. It is a term that encompasses the different techniques used to resuscitate a person after a sudden cardiac arrest. 

There are two important skills to know when doing CPR for both adults and children: 

Chest compressions: this is where you place the heel of one hand in the centre of the collapsed person’s chest, place the heel of your other hand on top of the first hand, interlock the fingers of your hands and push hard and fast on the chest to help pump blood around the person’s body. You should keep a steady rhythm of about 100-120 compressions every minute. Try humming ‘Baby Shark’ or ‘Stayin’ Alive’ to help you keep to the beat. 

Rescue breaths: also known as ‘mouth-to-mouth’, these give the person oxygen that could help them breathe again.  

Resuscitation Council UK recommends that during times of increased infection, e.g. the COVID-19 pandemic, people should carry out chest compressions only.

A cardiac arrest is when the heart has stopped pumping blood around the body and the person has become unresponsive. This may occur for many reasons, but loss of the electrical coordination that controls the normal heartbeat is usually responsible. 

The most likely cause is ventricular fibrillation, in which the normal orderly electrical signal that controls the heartbeat becomes completely disorganised and chaotic, and the heart is unable to act as a pump. 

No, the terms mean different things. Although ‘heart attack’ is often used to refer to a sudden cardiac arrest, this is incorrect.  

A heart attack (or myocardial infarction, to use the medical term) occurs when an artery supplying the heart with blood becomes blocked. During a heart attack the heart is still pumping, the person will remain responsive and have symptoms like chest pain and feel nauseated or sick. 

A heart attack may cause cardiac arrest, particularly in the early stages, but this is not inevitable. 

Because of this, the emphasis is on calling for immediate help to reduce the damage to their heart and reduce the risk of a cardiac arrest occurring. 

The Chain of Survival describes a sequence of steps that together maximise the chance of survival following cardiac arrest. 

What to do in a sudden cardiac arrest emergency, step by step.

Figure 1: Chain of Survival

The first link in the chain is the immediate recognition of cardiac arrest and calling for help. 

The second is the prompt initiation of CPR. 

The third is performing defibrillation as soon as possible. 

The fourth is optimal post resuscitation care in hospital, which begins with your explanation to the paramedics, when they arrive, of what has happened and your actions.  

Like any chain, it is only as strong as its weakest link. If one stage is weak, the chances of successful resuscitation are compromised. Early intervention in the first three stages is where a witness can make the biggest difference and increase the collapsed person’s chances of survival by 2-3 times.  
 

If bystanders who witness a cardiac arrest perform CPR, enough blood containing oxygen will reach the brain, heart and other vital organs to keep the person alive for several minutes. CPR by itself will not restart the heart, but it ‘buys time’ for the emergency medical services to reach the scene. Effective CPR more than doubles the chance of someone surviving a cardiac arrest. 

In the UK fewer than 10% of all the people in whom a resuscitation attempt is made outside hospital survive. Improving this figure is a major priority for Resuscitation Council UK, the Department of Health and Social Care, ambulance services and first aid organisations. 

When all the stages in the Chain of Survival take place promptly, the figures are very much better. This is possible where the cardiac arrest is recognised immediately, bystanders perform CPR, and an automated defibrillator is used before the ambulance service arrive. Survival rates in excess of 50% have been reported under these circumstances. 

Compression-only CPR describes the performance of uninterrupted chest compressions without rescue breaths. In many adults who suffer a cardiac arrest, the heart stops abruptly; breathing will have been normal (or nearly normal), so the blood should be well oxygenated. In this situation compression-only CPR may be effective for the first few minutes after the heart stops. This may provide time for the emergency services to arrive or an AED to be collected. 

Resuscitation Council UK recommends bystanders carry out compression-only CPR currently due to the potential increased risk of infection due to COVID-19. 


Early CPR can be the difference between life and death for a person in cardiac arrest.  

It remains important to attempt CPR if someone at home or in a public setting 
collapses and stops breathing or stops breathing normally (i.e. goes into cardiac arrest), while keeping bystander rescuers as safe as possible.  
  
Resuscitation Council UK (RCUK) developed COVID-19 related Guidance based on the best available evidence and clinical advice and has sought to balance maximising the chances of survival with rescuer safety. 

The Guidance is to place a cloth or towel over the mouth and nose of the person in cardiac arrest before starting CPR. It also recommends doing compression-only CPR. This means not giving rescue breaths (known as mouth-to-mouth).  

The important step of placing a cloth or towel over the mouth and nose of the person who has collapsed and is not breathing or not breathing normally before starting compression- only CPR is designed to help reduce the risk of aerosol transmission when performing the chest compressions. The cloth or towel will not obstruct or block the person’s airway. It will not impact their chances of survival. 

When an individual is in cardiac arrest, they will not be breathing normally, and without prompt CPR, their chances of survival significantly reduce. It is important to intervene and put the early steps of Chain of Survival (calling for help, performing CPR, and using a defibrillator) into motion as quickly as possible to give this person their best chance of survival. 

When the heart stops, blood supply to the brain also stops. The person will collapse, lose consciousness and will be unresponsive. The person will not be breathing normally, although it may take a few minutes to stop completely. For the first few minutes the person who has collapsed may take noisy, infrequent or gasping breaths.  

If you have any doubt whether someone is breathing normally or not, assume it is NOT normal: call 999 immediately and start CPR. 

An Automated External Defibrillator (AED) is a machine that analyses the electrical rhythm of the heart and delivers an electric charge/shock when an abnormal rhythm is detected.  

The reason this is important is because a sudden cardiac arrest (SCA) usually occurs when the normal electrical rhythm that controls the heart is replaced by a chaotic disorganised electrical rhythm called ventricular fibrillation. 

AEDs are compact, portable, easy to use and guide the operator through the process with prompts and commands. An AED precisely analyses the heart rhythm of the person who is unresponsive and will only deliver a shock if it is required. The sooner the heart is restarted, the better the casualty’s chance of survival.  

It can take 8 to 10 minutes for an ambulance to arrive so using a defibrillator could save a life. 

AEDs are very reliable and will not allow a shock to be given unless it is needed. They are extremely unlikely to do any harm to a person who has collapsed in suspected sudden cardiac arrest. They are safe to use and present minimal risk to the rescuer. These features make them suitable for use by members of the public with little or no training. 

Public Access Defibrillation describes the use of AEDs by members of the public. AEDs can now be found in many busy public places including airports, mainline railway stations, shopping centres, and gyms. They are meant to be used by members of the public if they witness a cardiac arrest. 

When you call the ambulance service you will be directed to the nearest registered device. Staff working at the location should also know the location of an AED nearby. 

In some places defibrillators are kept in a cabinet. If a cabinet is locked the emergency services operator will give you a code over the phone that you can use to unlock it.

People can still help even if they cannot do CPR themselves (e.g. they are not strong or confident enough).  

They can:  

  • recognise an emergency, call 999 and look out for the ambulance 
  • call out for someone else to help give CPR 
  • help someone else to perform CPR: 
    • talk them through the steps 
    • count chest compressions 
    • provide ‘moral support’ and reassurance that they are doing the right things 
       

It is very unlikely that someone in the UK who acted in good faith when trying to help another person would be held legally liable for an adverse outcome. No such action has ever been brought against someone who performed CPR and, in general, the courts in the UK look favourably on those who go to the assistance of others. 

Resuscitation Council UK has published detailed guidance on the legal status of those who attempt resuscitation. This provides answers to most of the commonly asked questions on the subject. 

In an emergency, it's usually in a person's best interests to commence resuscitation. 

If you are aware that the person has an up to date 'Do Not Attempt Cardiopulmonary Resuscitation' (DNACPR) recommendation, or Advanced Decision to Refuse Treatment in place, or has had a documented ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) conversation with a health care professionals, call the emergency services and they can advise what to do. 

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