BLS Education in Integrated Education: Saving Lives and Learning the Importance of Life

2024/05/20

On Saturday, March 2, the symposium "Practice and Social Significance of BLS (Basic Life Support) Education" was held at the Mita West School Building, hosted by the Keio University BLS Committee for affiliated schools and the Keio University Sports Medicine Research Center.

When a fine, trembling arrhythmia occurs in the ventricles of the heart, which act as a pump to send blood throughout the body, the heart can no longer perform its role. This leads to loss of consciousness within seconds and eventually to cardiac arrest. Therefore, it is essential for bystanders to immediately perform chest compressions (cardiac massage) and use an AED (Automated External Defibrillator) to deliver an electric shock to the heart to normalize the heartbeat. BLS education aims to enable anyone to put these methods into practice immediately.

At Keio University, BLS education began in 2002 across all affiliated schools from the elementary to high school levels and continues to this day. The year 2022 marked the 20th anniversary, but due to the COVID-19 pandemic, an event to reaffirm its pioneering nature and social significance could not be held at that time, so it was held this year instead.

The catalyst for the start of BLS education at the Juku was a tragic incident in 1998 where a student passed away during a marathon at Shiki High School. Following a proposal from Shingo Hori, then Deputy Director of the Emergency Department at the School of Medicine, and Hajime Yamazaki, then Director of the Sports Medicine Research Center, BLS education began at Shiki High School the following year. Then, in 2001, when Mr. Yamazaki took office as the Vice-President in charge of affiliated schools, he organized the BLS Committee and advocated for its implementation across all stages of integrated education, leading to its adoption in all schools starting in 2002.

Initially, there seemed to be some confusion at each school. However, by ensuring that BLS education is provided at every stage of schooling, several educational benefits were confirmed: first, skills improve through repeated practice each time a student advances to a higher school; and second, it becomes a program that goes beyond simply acquiring life-saving techniques to instill judgment in emergencies, crisis management, the dignity of life, and civic duties. Furthermore, the momentum was driven by the accumulation of practice and awareness unique to Keio University's various institutions. This included not only the Department of Cardiovascular Medicine at the School of Medicine but also the Sports Medicine Research Center, which had over a decade of experience in medical checks for Kanagawa Prefecture National Sports Festival athletes and professional sumo wrestlers to prevent sudden death during competition, as well as awareness raised through surveys on sudden deaths among high school students in Yokohama. The Emergency Department of the School of Medicine had also been focusing on sudden death and commotio cordis (cardiac arrest caused by a strong impact to the chest during sports) even before the Japanese term for it became established.

The year 2002, when BLS education began in all schools, was also the year Prince Takamado passed away suddenly while playing squash. At that time, AEDs could not be used without specific instructions from a doctor, but discussions progressed following the Prince's passing, and it was exactly 20 years ago, in July 2004, that they became available for use by the general public. Keio University began installing AEDs in each school slightly ahead of this, largely influenced by the experience of Keio Academy of New York, which had already installed them in accordance with New York State's 2002 mandate for public schools.

At the symposium, after the author introduced these developments in a presentation titled "The Beginnings and Subsequent Development of BLS Education at Keio University," Akiko Koyama, a teacher at the Girls' Senior High School, gave a lecture titled "The Practice of BLS Education in Keio University Integrated Education." As a member of the BLS Committee since its inception, she reflected on the initial challenges and provided a detailed introduction to the initiatives and transitions at each school. The methods vary by school; in addition to being part of health and physical education classes, schools receive diverse cooperation from outside, such as medical professional alumni (Yochisha Elementary School), Athletic Association trainers (Shiki High School), and local fire departments (Fujisawa Junior and Senior High School). The Girls' Senior High School had received help from KAPPA, a student organization from the medical-related faculties dedicated to spreading CPR, but since the pandemic, third-year students have been participating in instructing first-year students as teaching assistants within the school.

Next, under the title "Social Significance of BLS Education from the Perspective of Utstein Statistics (Fire and Disaster Management Agency Out-of-Hospital Cardiac Arrest Data) Analysis," Aya Yuzawa and Kazuhiro Shirakawa, graduates of the Graduate School of Health Management, presented empirical analysis results such as "Typology of Out-of-Hospital Cardiac Arrest (Are people who collapse in the city being saved?)" and "Differences in Resuscitation Rates by Bystanders of Out-of-Hospital Cardiac Arrest (Are family members being saved?)." Furthermore, Hiroyuki Ishida, Professor at the Sports Medicine Research Center and Dean of the Graduate School of Health Management, gave a lecture titled "How to Prevent Sudden Death During Sports Activities."

In addition to Ms. Koyama and Mr. Ishida, a panel discussion was held with Junichi Sasaki, Professor of Emergency Medicine at the School of Medicine, and graduates who had received BLS education. During this, Yuri Banno, a fifth-year medical student, shared that receiving repeated BLS education since her time at Yochisha lowered the psychological hurdle to saving people, and that her current activities as a member of KAPPA stem from realizing the importance of fostering people who take the initiative to help others. Also, Michitaro Hayakawa, a graduate of the School of Medicine who now assists with training at Yochisha, spoke about the importance of establishing accurate knowledge and skills during the junior and senior high school stages, drawing on his experience competing in lifesaving competitions during his university years. In response to these comments, Mr. Ishida and Mr. Sasaki expressed their expectations for moving to the next stage by developing a Keio-style system where those who learned at each affiliated school teach their juniors, with faculty members working as one.

At the end of the symposium, Hideo Mitamura, Chairman of the AED Foundation and former professor at the School of Medicine, who has consistently engaged in public awareness activities, introduced national examples of "Children saving, children being saved." He concluded the event by speaking about the significance of BLS as a form of moral education, stating that the experience of working hard to save an individual's life fosters people who value human life.

When Keio University first began BLS education, it strove to raise awareness through media outlets and other channels. In the current Course of Study (Academic Advisory Board guidelines) revised a few years ago, both junior and senior high schools are now required not only to understand but also to be able to perform CPR. With BLS education becoming commonplace and explained in detail even in elementary school textbooks, the symposium served as an opportunity to reaffirm the social significance of Keio's role and to share the responsibility of advancing this to the next level.