Traditional certificate-based CPR courses designed for lay rescuers often entail a several-hour time commitment and cost approximately $50. They are useful for individuals who wish to receive additional training or whose jobs require certification. In 2010, about a quarter of SCA victims in the CARES registry (Cardiac Arrest Registry to Enhance Survival) received CPR prior to arrival of EMS. That proportion is consistent with training data suggesting 20% of the population had been trained in CPR in the previous five years. CPR is a psychomotor skill which requires practice to create muscle memory, but even a few minutes of practice may be sufficient to perform effective chest compressions in an emergency.⁷ Training enough people in CPR to ensure that the lifesaving procedure will be provided for at least half of the witnessed OHCA cases in a community requires reaching a very significant portion of the population. However, with the introduction of short skills training, such as compression-only CPR in 10 minutes or less, the task may not be as daunting as it appears.

Attempts to train many community members using traditional methods have had limited impact in most communities. This clearly requires a concerted effort. The menu of activities used to accomplish this may include:

• Integration into the curriculum of local schools
• Encouragement of businesses to provide CPR training for their employees
• Offering short training sessions at health fairs, and ongoing training at local fire stations or other health or training facilities
• Ensuring that high-risk patients and their families are trained in CPR before discharge from the hospital

One way to get significant media exposure is to hold a mass CPR training event. While these events require extensive planning relative to the number of people trained, many more people are made aware of CPR through the media coverage. Involvement of celebrities and cardiac arrest survivors with compelling stories can facilitate media coverage. Typical events require planning up to a year in advance. Large scale CPR/AED training activities can involve a few or many local groups such as:

• Local celebrities, media and politicians
• Local champions, medical professionals and survivors
• Sports teams
• Churches
• Clubs, community organizations, hospital initiatives
• Colleges and universities, local school groups

Training efforts need to be ongoing and sustainable, necessitating commitment from community institutions such as churches and schools. Large and small organizations and companies, can offer CPR training as a part of the companys human resources orientation program so that new employees can be trained as they are hired and existing employees can obtain refresher training on a regular basis. This level of effort requires both personnel and resources and takes a significant commitment.