The American Heart Association (AHA) recently made two announcements that may have you thinking, "Whaaat?!".  Four-year-olds and Taylor Swift can save lives. You heard it right, so let's bring you up to speed.

• Counting ten or more objects

• Correctly naming at least four colors and three shapes 

• Recognizing some letters and possibly writing their name.

These are the typical knowledge milestones of a 4-year-old, but we can now add another item to the list - identifying a cardiac situation and dialing 911.  

In May 2023, the American Heart Association, the European Resuscitation Council, and the International Liaison Committee on Resuscitation published a scientific statement in the journal Circulation that details evidence showing schoolchildren as young as 4 know how to call for help in a medical emergency and that, by age 10 to 12, children can administer effective chest compressions when performing cardiopulmonary resuscitation, better known as CPR.

With an incidence of 67 to 170 per 100 000 inhabitants, out-of-hospital cardiac arrest (OHCA) is a leading cause of death worldwide. The location of Out of Hospital Cardiac Arrests (OHCA) most often occurs in homes/residences (73.4%), followed by public settings (16.3%) and nursing homes (10.3%). Survival rates range between 2% and 20% and are particularly low without an immediate bystander response. 

During cardiac arrest, the heart stops pumping blood to the brain and other vital organs. As a result of a decrease in blood flow to the brain, a victim will fall unconscious. The brain can suffer damage in as few as three minutes without proper blood flow. There can be irreversible damage after nine minutes without blood flow to the brain. CPR helps to keep blood flowing and may help minimize the damage to the victim. 

Various medical groups have long stressed the importance of teaching young children what to do during medical emergencies at home, school, or other settings. An important component of the chain of survival is knowing how to call emergency medical services and what information to provide in the call. Evidence from the published literature shows that teaching children as young as 4 years of age can lead to improved knowledge about how to call for help.

In 2018, the American Academy of Pediatrics released a policy statement advocating for training children, parents, caregivers, school personnel, and the public on basic lifesaving skills and the appropriate use of AEDs. As part of educating children about lifesaving skills, "teach young children how to assess consciousness and normal breathing," the scientific statement says. 

In training schoolchildren, the approach recommended by the International Liaison Committee on Resuscitation uses a simple algorithm such as CHECK-CALL-COMPRESS. The simplified CHECK assessment includes speaking to the patient, waking them up, and then looking, listening, and feeling for normal breathing. There is evidence that young school children 4 to 15 can correctly reproduce assessments for consciousness and breathing after a demonstration and hands-on practice.

The American Heart Association has played a role in getting more than 40 states to require some type of education about cardiac arrest and CPR as a graduation prerequisite for high school students.  CPR training for younger students can encounter some limitations as it is a physically demanding skill. Age may not be the most important variable; a child's weight or body mass index may be just as important. Compression depths achieved by schoolchildren on manikins after CPR training vary widely and depend on their body size, which can vary by age and sex. Minimum body weights are required to achieve sufficient force for adequate depth of compressions. However, studies suggest that correct hand positioning and compression rates can be delivered by schoolchildren beginning at 10 years of age.

Suggestions for School Children Training

• Teach young children the correct compression depth and rate, although they may not achieve them to guideline standards.

• For school children, focus on the key components of high-quality CPR: minimizing chest compression interruptions, correct chest compression rate and depth, and full chest recoil.

• Provide an opportunity to practice BLS skills during training and retraining.

• Use cognitive aids (e.g., metronomes, music at 100–120 bpm) or real-time feedback devices.

And it's the last bullet that leads us to Taylor Swift.

Taylor Swift's "The Man"

This summer, Taylor Swift is traversing the country with her Eras Tour, the song set which may or may not include her song "The Man." While the song off her 2019 "Lover" album may not be one of her more popular tunes, only peaking at 23 on the US Billboard chart, the American Heart Association is loving "The Man." Why?  Because it has the perfect tempo to perform hands-only CPR, an ideal accompaniment for teaching all those schoolchildren and graduating seniors the lifesaving skill. Coming in at 110 beats per minute, it's the right tempo to keep the CPR compressions at the right speed.

Not a Swiftie?  Other songs from many generations and genres can help you keep true to the 100-120 beats per minute.  Find a favorite from the list below (or do a quick Google search as there are many CPR- friendly playlists out there) and be ready to take action should the unfortunate occasion arise as "every minute counts."

• "Stayin' Alive" - Bee Gees

• "Baby Shark" - Pinkfong

• "Dancing Queen" - ABBA

• "Cecilia" - Simon & Garfunkel

• "Hard To Handle" - The Black Crowes

• "Sweet Home Alabama" - Lynyrd Skynyrd

• "Rock Your Body" - Justin Timberlake

• "I Will Survive" - Gloria Gaynor

• "MMMBop" - Single Version. Hanson

• "Gives You Hell" - The All-American Rejects

• "History of Rap" - Jimmy Fallon, Justin Timberlake

• "Girls Just Want to Have Fun" - Cyndi Lauper

• "Crazy in Love" - Beyonce, Jay Z

• "Just Dance" - Lady Gaga, Colby O'Donis

• "Something Just Like This" - The Chainsmokers, Coldplay

• "Rumour Has It" - Adele

• "Sorry" - Justin Bieber

• "Rock This Town" - Stray Cats

• "Fly" - Sugar Ray

• "Hips Don't Lie" - Shakira

• "Work It" - Missy Elliott

• "What's Going On" - Marvin Gaye

• "Suddenly I See" - KT Tunstall

• "Crazy" - Gnarls Barkley

• "Spirit In the Sky" - Norman Greenbaum

• "Man in the Mirror" - Michael Jackson

• "One Week" - Barenaked Ladies

• "Another Brick in the Wall" - Pink Floyd