Child safety remains a top priority among Howard County Public School System bus drivers as they join hands with the county's Department of Fire and Rescue Services for CPR training sessions before the start of the school year later this month.
Back-to-back, two-hour sessions began in mid-July and continued this week at Centennial High School in Ellicott City, where Transportation Director David Ramsey said more than 700 bus drivers and attendants are learning how to perform CPR for adults, children and infants.
"Each year, all of our bus drivers and attendants receive annual safety training," Ramsey said. "It's a code of Maryland regulation and, every three years, we're required to provide first-aid training that is basic first-aid. This year, we're taking it a step up and providing the CPR training."
After hearing about the fire department's training sessions, Ramsey said the school system "took them up on the offier because we hadn't offered CPR training in many, many years."
"[The fire department] said they are readily willing and available and it's very important to their mission to train as many citizens as possible in CPR," he said. "We want our folks to be the very best of the best."
CPR instructor Kathryn Larkins said she is applying specific scenarios bus drivers may encounter, such as choking or cardiac arrest.
"These bus drivers see and deal with a lot of kids every day," Larkins said. "A lot of times, they're with them for an hour in the morning and an hour in the evening. In that little bit of time, anything can happen."
During Thursday's training session, Larkins reviewed the different methods of CPR for all ages from infancy to adulthood. After checking for an adult's response and breathing, Larkins said a person can begin CPR by using the heel of the hand for two-minute 30-compression intervals, pushing down approximately two inches to the beat of songs, like the Bee Gees "Stayin' Alive" or Bruno Mars' "'Uptown Funk."
"Certification classes teach you how to use different devices," she said. "You don't have to have a certification to perform CPR. It's a lot easier. All they have to do is just push on the chest and you don't have to give breaths [for adults]."
When using CPR on a child, Larkins said, the process requires an additional step, where the performer gives mouth-to-mouth to the child with two small breaths following the 30 compressions. For infants, the performer will only use two fingers during the compressions, pushing about an inch and a half down on the infant's stomach. Once again, they will perform mouth-to-mouth, but will do so by placing their mouth over the infant's mouth and nose.
Transporting more than 40,000 students each morning and afternoon of the school year, Ramsey said, bus drivers and attendants must be able to respond appropriately in the case of an emergency.
"The quicker you can administer the first-aid, the more likelihood that the person will live," he said.
That exact logic ran through the mind of county bus attendant Sheryl Harrison last year when a medically disabled student went into cardiac arrest as the bus was entering the Cedar Lane School parking lot.
"I sit in the back of the bus when I have the children in wheelchairs in the back," Harrison said. "The little boy was sleeping and he just went limp. His head fell down and his arms fell."
Harrison said she immediately alerted the bus driver, Les Hendry, who called 911. Once Harrison realized the child was no longer breathing, she opened up his jacket and began the chest compressions she learned in CPR certification.
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"I listened again and I still didn't hear anything and his chest wasn't rising," she said. "Since he was physically fragile, I felt it appropriate to do the infant compression [by using lighter compressions] and he just jumped and threw his arms and kicked his legs and started breathing."
Although many associate cardiac arrest with adults, Larkins said that is not always the case.
"The past couple of months, we've had a couple kids go into cardiac arrest; a 13-year-old and a 16-year-old," she said, referring to incidents of Howard County first-responders. "Even though [bus drivers] only spending an hour or two with these kids, they see all the kids in Howard County at some point. Whatever they can do, it's something. It's better than standing back and not doing anything and waiting for an ambulance to get there."
While performing CPR can lead to physical injury due to pressure put on the chest from compressions, Larkins said the Good Samaritan Law offers legal protection to those who give reasonable assistance to help the injured.
"You're pushing on their chest. Most likely, you are going to hurt somebody," Larkins said. "They're not going to feel it. You could break a rib or puncture a lung, but they can heal from it. We can fix that. Once a heart has been stopped for too long, you can't fix it."
Hendry said this year's mandatory CPR training is valuable for both drivers and attendants. With it, he and Harrison were able to save the child's life.
"I'm the driver and I'm responsible and I'm in the position where I can't help," Hendry said. "I could've been going down Route 29 going 55 miles an hour when this happened. We were fortunate that we were doing 30 miles an hour in front of the school. Without [Harrison], Lord only knows where [the student] would be today."