RENO — To make CPR training among high school students and athletes more effective and save more lives, Dr. Lorrel Toft, a cardiologist and associate professor at the University of Nevada, Reno School of Medicine, is developing interactive films and other digital media with funding from the National Institutes of Health in collaboration with Coram Technologies.
Associate Professor Toft received a two-year, $1.48 million grant from the NIH in September 2023 to use interactive digital media to teach CPR to high school students.
This grant builds off her work to create realistic, interactive films to train student-athletes to identify cardiac arrest and give immediate CPR on the field, which was first funded by a three-year $400,000 grant from the American Heart Association in 2019.
“We want to equip and empower athletes to be ready to respond if they ever have a teammate who collapses from cardiac arrest,” Toft said. “Every minute of delay to giving CPR or defibrillation decreases survival by 10%.”
More than 350,000 people in the U.S. experience an out-of-hospital cardiac arrest each year, and fewer than 11% of them survive. Being near someone who can perform CPR improves a person’s chance of survival, but training rates in the U.S. are low.
While 43 states require high school students to learn CPR, only 30% of students can perform high-quality CPR immediately after training, and Toft’s research shows fewer than half retain that knowledge six months later.
Recent high-profile professional athletes suffering cardiac arrest on the field have drawn attention to the need for effective training. Cardiac arrest is the leading cause of death in high school athletes, standing at one in 50,000 to 80,000 students each year.
The nature of these cardiac arrests and the potential delay in getting help on the field make high school athletics an important niche where Toft and her team can make a difference.
“Getting trained to give CPR is important, but we can be more efficient and effective with training as a nation,” she said. “I focus on high school because that’s where the opportunity lies, but there are many other applications.”
The training film her team will develop focuses on helping students and athletes identify the signs of cardiac arrest — to separate them from other common athletic injuries — and learn how to respond quickly. With additional education, teammates can feel confident in their ability to quickly assess and act on the field before medical professionals arrive.
Toft’s goal is to increase the retention of CPR skills among students, advance CPR training in high schools and eventually push the training to professional athletes.
“It’s a simple idea, but it moves the needle in a significant way,” Toft said.
The interactive CPR training films directly engage students by showing them a scenario and pausing to ask alternating student teams direct questions. This approach ensures they engage in active rather than passive learning and competition to enhance learning.
“So, the 911 dispatcher will say, ‘Are they breathing?’ Then the film pauses, and we ask the audience, ‘Is he breathing yes or no?’ Then we move on to the next part of the film,” Toft explained.
The film also addresses the emotional and psychological impacts of needing to give CPR to a friend or teammate.
“We are trying to mimic the situation during training and evoke realistic feelings so those intense feelings won’t paralyze someone if they encounter a real cardiac arrest,” Toft said.
Of particular importance is addressing how to perform CPR on women as some people may be more afraid of giving CPR to a woman, which can hinder the care female victims receive.
The NIH grant will specifically address how to perform CPR on women by addressing barriers, such as fear of inappropriate touching, and it will also be the first CPR training in the U.S. to feature a female victim.
“Even in virtual reality, women receive CPR less often in public than men do,” Toft said.
In the end, Toft hopes to develop an entire system of interactive CPR training films that are adopted nationwide across high schools, sports teams and beyond, using different scenarios and new techniques that stick with students longer.