In 2024, two Michigan high school students were sitting in the bleachers during a student-teacher basketball game when their physical education teacher collapsed from cardiac arrest. They had both recently learned cardiopulmonary resuscitation (CPR) at a career-focused technical nursing center and rushed to help, beginning chest compressions and using an automated external defibrillator (AED) before emergency responders arrived.
Thanks to their actions, their teacher survived, and is one of approximately 350,000 Americans who experience an out-of-hospital cardiac arrest each year. Roughly nine out of ten will not survive.
We often describe the difference between life and death as a matter of speed: how quickly emergency services arrive and how fast a hospital can intervene. But in reality, cardiac arrest outcomes often depend on whether someone nearby begins CPR in the first few minutes, which rarely belong to emergency responders, but instead to whomever is standing closest: a classmate, teacher, stranger at a basketball game, or someone waiting for a train. Every minute without CPR sharply reduces the chances the patient will live long enough to reach a hospital.
Schools occupy a special role in public health. As a location most Americans pass through and one of the only places they may ever encounter CPR training, a high school classroom may be the best opportunity to prepare the next generation of lifesavers.
Schools already rehearse fire drills and lockdown drills for dangers that are statistically rare. Cardiac arrest is the reverse: far more common, and far less rehearsed. CPR skills can save lives years down the road when a cardiac arrest occurs at home, in a gym, at an airport, or at a university. Harnessing that opportunity requires both the resources to teach CPR effectively and the policies to ensure every student has the chance to learn it.
In Europe, Belgium, Denmark, France, Italy, Norway, Portugal, and England implemented school CPR education through national requirements or curriculum standards. Denmark offers a clear example of the positive impact. From 2001 to 2010, as Denmark introduced nationwide resuscitation initiatives including mandatory school CPR education, bystander CPR rates more than doubled, while 30-day survival after out-of-hospital cardiac arrest more than tripled.
A central challenge is how to implement CPR training at scale. The international KIDS SAVE LIVES initiative offers a practical blueprint. Endorsed by the World Health Organization, it calls for recurring, age-appropriate basic life support education beginning in childhood. Research from the International Liaison Committee on Resuscitation shows children can learn the early links in the chain of survival from the young age of 4, perform effective chest compressions by age 12, and pass skills to family members and others.
Some may hesitate to perform CPR because of legal concerns over causing injury—like rib fractures—while administering CPR, but every state has Good Samaritan laws providing protections to people who render emergency aid in good faith. A 30-year review of U.S. litigation across all 50 states from 1989 to 2019 found no cases in which a layperson who provided CPR was held liable for causing harm.
The U.S. has also made significant progress in bringing CPR education into schools. In 1984, Alabama became the first state to require CPR instruction for high school graduation. Over the four decades since, communities have taken different approaches to bring CPR into the classroom. In West Virginia and Alaska, educators’ unions formally backed legislation requiring CPR education, while efforts in Washington and Illinois advanced in memory of students lost to cardiac arrest.
Today, 43 states require some form of CPR education before high school graduation. California, Colorado, Hawaii, Massachusetts, Nebraska, New Hampshire, and Wyoming are the seven that remain. Several are already taking steps to expand CPR education. Massachusetts invested $425,000 to expand CPR education in public schools, while Colorado includes hands-on CPR and AED instruction in its statewide health education guidelines but stops short of requiring schools to provide it. California Gov. Gavin Newsom recently signed a resolution directing the Instructional Quality Commission to include high school CPR in the state’s next health curriculum framework. San Francisco is taking an even broader approach, with paramedics and firefighters working to train 100,000 community members in CPR.
There is evidence that laws can translate into lifesaving action. A study of nearly 300,000 out-of-hospital cardiac arrests across 20 states found that patients had 12% higher odds of receiving bystander CPR in states with high school CPR education laws than those without them.
Other lifesaving education efforts can also offer a roadmap. In Georgia, Wesley’s Law, championed by Laura and Larry Gay after their son’s death, required public schools to stock overdose-reversal medication such as naloxone. In 2025, the state launched an opioid-settlement-funded initiative to provide overdose-reversal kits to public schools statewide, along with training resources for staff. In Indiana, emergency-response professionals helped expand Stop the Bleed training in schools, and the state’s Secured School Safety Grant program now offers funding for school bleeding-control programs and kits.
Both examples demonstrate how local champions and an existing source of funding can help turn a lifesaving idea into reality. Broadening collaboration among organizations such as the American Medical Association, American Red Cross, Project ADAM, and American Heart Association can also help expand CPR education nationwide.
After Buffalo Bills safety Damar Hamlin suffered cardiac arrest on the field in 2023, he became a leading advocate for the bipartisan HEARTS Act, which Congress passed unanimously in 2024. President Biden signed it into law later that year, supporting schools in expanding access to AEDs, CPR and AED education, and cardiac emergency response planning.
Cardiac arrest does not wait for emergency responders. The students who stepped forward when their teacher collapsed playing basketball in Michigan illustrate what becomes possible when CPR skills are taught before they are needed. Someday, every high school student in the U.S. could graduate prepared to step up and become a lifesaver.