When it comes to learning CPR, easy does it

One stormy evening last April, Matt Lickenbrock, a 21-year-old University of Dayton student, helped save a life: He performed cardiopulmonary resuscitation (CPR) on a fellow student felled by a lightning strike.

Amazingly, Lickenbrock had learned the basics of CPR only two days earlier — not in a traditional class, but at a video training kiosk set up by the American Heart Association at the Dallas/Fort Worth International Airport.

Thanks to that chance opportunity during a spring break layover, "I knew exactly what to do," Lickenbrock says.

Far too few people can say the same, medical experts say. Despite decades of public information campaigns and the wide availability of formal training, just one third of U.S. adults say they would be comfortable attempting CPR, the heart association says. Fewer than 3% take a training course each year, according to a recent review from the Institute of Medicine.

That lack of readiness, the institute said, contributes to a dismal survival rate for the 600,000 Americans who each year collapse in cardiac arrest —  a life-threatening emergency in which electrical disturbances stop the heart, leaving victims unconscious, not breathing or breathing abnormally. Cardiac arrest can be triggered by a heart attack, other illnesses, electrocution or drowning. Death typically occurs in minutes, but some people can be saved if CPR quickly gets blood flowing to the brain and a shock from a defibrillator restarts the heart.

In hospitals, the survival rate is 24%; outside hospitals, where immediate CPR and defibrillator use are much less common, it's about 6%, the institute reported.

That's why the heart association and other groups are trying new ways to teach the public CPR — and to convince people that, with or without formal training, they can make a difference.

"We want to create a stronger culture of action," says Clifton Callaway, a professor of emergency medicine at the University of Pittsburgh who chairs a heart association committee on emergency cardiovascular care.

Among efforts to increase bystander CPR:

• Spreading the "hands-only" word. In CPR guidelines updated this month, the heart association re-emphasizes a simple message: In most cases, anyone can start CPR using rapid chest pushes —  no mouth-to-mouth breathing required. People fully trained in CPR should still combine breaths and chest pushes, the association says, but anyone can do the basics. As the group's online videos teach: "Call 911 and then press hard and fast on the center of the chest … until help arrives."

• Teaching the rhythm. The most effective rate is 100 to 120 chest pushes a minute — which, appropriately enough, matches the beat of the disco classic Stayin' Alive. Lickenbrock says the airport training video used that Bee Gees song, and he had it in his head as he performed CPR two days later.

• Embracing technology. "The world has changed," Callaway says, and "everybody has a phone on their person." That means you can call 911 from anywhere, then use speaker mode to be coached through CPR. If you are trained, in some cities, you can download an app that will alert you when someone nearby needs CPR. Other apps can give you a metronome beat for chest pushes or tell you where the nearest automated external defibrillators (AEDs) are. And the AEDs now in many airports, schools and offices are designed so that anyone can follow instructions and safely use them. (If there is no defibrillator, the idea is to continue CPR until professionals arrive with one).

• Taking training to schools. In September, New York and Illinois became the 26th and 27th states to require CPR training for high school graduation. That's up from two states four years ago.

• Taking training to public places. The Dallas/Fort Worth airport training kiosk was a first, but six more training kiosks, including at least four at airports, will roll out in 2016, the heart association says.

Traditional CPR training in a class with a live instructor, repeated every couple of years, remains the gold standard, says Richard Bradley, chief of emergency medical services at the University of Texas Health Science Center at Houston. Bradley is an adviser to the American Red Cross, which trains 2 million people a year.

But, he says, "if someone sees a cardiac arrest and they've never been trained, we don't' want them to say 'I've never been trained, so I can't do anything.' "

So why don't more people attempt CPR? Bradley and Callaway say the reasons can include:

• Not recognizing cardiac arrest. The major signs are total unresponsiveness and absent or abnormal breathing. "It's very dramatic, it's very serious, and your first reaction may be that this is not really happening," Callaway says.

• Fear of doing harm. People worry that they will push too hard and crack a rib. While that can happen, it's not life-threatening (unlike cardiac arrest), the doctors say. Also good to know: automated AEDs won't shock people who don't need shocks. And "good Samaritan" laws protect you from liability.