New Jersey School District Gets Prepared with Bleeding Control and CPR Training

In March 2014, a high school track athlete at New Jersey’s Pascack Hills High School suffered a cardiac arrest while running before practice. He was successfully resuscitated by his coach, two teammates who happened to be EMTs, and the school’s athletic trainer, who had an AED. “As a result of this incident, our district experienced the powerful impact CPR can have on saving a life,” says P. Erik Gundersen, superintendent of the Regional School District. “As a result, our administrative team, in conjunction with our physical education department, established a lofty but important goal of having each member of our school community become not just trained but certified in CPR.”

Janet’s Law

Later that year New Jersey passed NJSA 18A:40-41a–41c, otherwise known as “Janet’s Law.” This law requires all public and private schools in the state to have an AED on site, a minimum of five school employees certified in CPR/AED, and an emergency action plan for a sudden cardiac event. But based on its 2014 incident, the Pascack Valley Regional High School District (PVRHSD) felt it was important to exceed the state requirement. “We were already training our 11th-graders in CPR in health class. We felt the need to expand this by getting our teachers qualified as instructors and then certifying our students,” explains PE/health supervisor Joseph Orlak. 

Partnering with the Fairfield-based company Lifesavers, Inc., PVRHSD certified all its PE/health teachers as American Heart Association CPR Instructors and purchased hundreds of manikins, training aids, and supplies. Starting in the 2015–16 school year, the district undertook the enormous task of certifying all district students, faculty, and staff in CPR and AED use. Training was conducted during students’ health classes, during teacher preparation periods, during lunch, and after school throughout the year. In all more than 2,500 individuals were certified, and the district has allocated funds to continue this training and certification every year since. 

This program has been so impressive that the American Heart Association recognized the district in 2016, giving the PVRHSD its annual Lifesaver Award for promoting the chain of survival for cardiac events. According to the AHA, Pascack Valley is the only school district in New Jersey where all members of the school community are certified on a biyearly basis. According to a detailed 2009 research study from the Journal of Athletic Training, United States high schools with AED programs were more likely to ensure access to early defibrillation, establish emergency action plans, consult local emergency medical services, review and regularly rehearse their emergency action plan, and implement a communication system to activate emergency services.

Adding Bleeding Control

When PVRHSD director of curriculum and instruction Barry Bachenheimer, who is also an EMT, took an NAEMT Tactical Emergency Casualty Care course in 2016, he saw the value of having supplies to control massive hemorrhage on hand in the schools and people trained to use them. Using funds from a federal grant for health and safety, Bachenheimer purchased wall-mounted public access bleeding control kits for the schools and had them placed near the multiple AEDs in each building. Additionally, individual first aid kits were purchased for the school district’s nurses, administrators, and security officers. Each kit contains tourniquets, wound-packing gauze, chest seals, and pressure bandages, and the wall-mounted kits also have emergency litters.

As a bleeding-control (B-Con) instructor, Bachenheimer used district professional-development days to train multiple school personnel in massive-hemorrhage control, including use of tourniquets, hemostatic gauze, wound packing, chest seals, and hypothermia control. At first faculty and staff were a little apprehensive, but they quickly realized that with training, the skills were very manageable. Matt Miller, a retired police lieutenant who works as one of the district’s security officers, says, “I had been trained as a first responder years ago, and we were originally taught that tourniquets were a tool of last resort. Now, based on the current research, I see they’re a valuable tool. I still hope I never have to use one, but I’m glad our schools are prepared.”

PVRHSD students have a strong history of community service and public safety training. Dozens every year get EMT or firefighter training and volunteer on one of the four ambulance squads and fire departments in the area. Others volunteer at Pascack Valley Hospital or intern in local physicians’ offices. As a result school leaders decided to train interested students in bleeding control. Students received training utilizing the same B-Con curriculum during the “Pascack period,” a 90-minute free-choice period students have once a week. Additionally, forensics teacher Russell Grier partnered with Bachenheimer to teach all 125 of his science students B-Con skills as part of a blood-analysis unit in the curriculum. After noting that many of the civilian rescuers at recent violent events in Las Vegas, Orlando, and Parkland, Fla., had to resort to using homemade tourniquets, students conducted experiments to see what kind of noncommercial tourniquets would work best in an emergency.

Research Supports

Making tourniquets and other bleeding-control supplies widely available to the public is an idea whose time has come. As the danger from hemorrhage has become ever more apparent, responsibility for controlling it has been delegated down from the surgeon to the paramedic and eventually to individual service members and civilian bystanders via Stop the Bleed and other training programs. In a study conducted at UT Health San Antonio between September 2016 and March 2017, researchers found “a short educational intervention can improve laypersons’ self-efficacy and reported willingness to use a tourniquet in an emergency. Community education should continue to be a priority.” 

The subjects of this study, civilians without medical training, were initially asked if they would use a tourniquet in real life, and 64.2% said yes. Following the training, 95.6% of participants reported they would use a tourniquet in real life. When participants were asked about their comfort level in doing so, there was a statistically significant improvement between their initial response and their response post-training.

Preparedness Counts

After the February school shooting in Parkland, Fla., the PVRHSD, much like schools across the nation, reevaluated its preparedness. Beyond the security personnel, frequent drills, passive and active security measures, constant collaboration with local law enforcement, and enhanced communication systems it has in place, PVRHSD continues to see value in training and equipping its faculty, staff, and students with the knowledge and skills to possibly save lives prior to EMS arrival.

The Pascack Valley Regional High School District, located in Northeast Bergen County, N.J., serves more than 2,000 students from the towns of Montvale, Hillsdale, River Vale, and Woodcliff Lake. 

References

Hawk AJ. How Hemorrhage Control Became Common Sense. J Trauma Acute Care Surg, 2018 Feb 27 [epub ahead of print].

Ross EM, Redman TT, Mapp JG, et al. Stop the Bleed: The Effect of Hemorrhage Control Education on Laypersons’ Willingness to Respond During a Traumatic Medical Emergency. Prehosp Disaster Med, 2018 Apr; 33(2): 127–32. 

Toresdahl BG, Harmon KG, Drezner JA. High school automated external defibrillator programs as markers of emergency preparedness for sudden cardiac arrest. J Athl Train, 2013 Mar–Apr; 48(2): 242–7. 

Barry Bachenheimer, EdD, FF/EMT, is a firefighter and member of the technical-rescue team with the Roseland (N.J.) Fire Department and an EMT with the South Orange (N.J.) Rescue Squad. With an emergency services career of more than 30 years, he frequently serves as an instructor for both departments. He is also the director of curriculum and instruction for the Pascack Valley Regional High School District (N.J.). Reach him at bbachenheimer@pascack.org.