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Date Published: April 22, 2026
When minutes matter, children can be the unlikely hero. That’s not an inconceivable notion. Pediatric emergency medicine specialist Dr. Elizabeth Hewett Brumberg is a key contributor to the American Red Cross’s Scientific Advisory Council. She provides evidence that children as young as four years old are capable of learning—and applying—lifesaving skills.
Research shows that children can begin learning and retaining first aid and resuscitation skills much earlier than we think. At age four, for example, they can recognize emergencies, call the correct emergency number, and provide key information like their location. Though the science is still being evaluated, there is some evidence to show that grade-school and middle-school children can learn skills such as chest compressions and bleeding control if they are given age-appropriate training.
Parents and schools both play vital roles in teaching children essential life skills. Parents can model positive behavior, reinforcing what children learn. Additionally, kids often mimic skills they learn at home, so it's important for parents to be open and encouraging.
Schools are especially well-equipped to teach lifesaving skills because educators understand children’s developmental and emotional needs.
Since maturity varies widely among kids of the same age, teachers can tailor instruction accordingly. While implementing such programs can be challenging due to funding, training, and time constraints, research shows they can be integrated into existing curricula with minimal time investment, such as one hour per week. Periodic retraining helps maintain these skills.
Broad access to first aid and CPR training is a central consideration in emergency preparedness.
Dr. Elizabeth Hewett Brumberg emphasizes how important it is to work on making lifesaving training widely accessible. It prepares students to help others in emergencies, even by taking the simple action of calling 911, potentially saving lives.
Some concerns have been raised about potential negative psychological effects of early first aid training, but Dr. Elizabeth Hewett Brumberg notes there is no data supporting this. In fact, research suggests the opposite: early training in resuscitation and first aid can increase empathy, promote helping behaviors beyond emergency situations and reduce risk-taking in adolescents by making them more aware of the consequences of dangerous actions.
In an emergency, it’s clear that minutes matter. Having more people — including children — in the community who have had training will increase the number of people who get help in those first few minutes before EMS arrives.
Good morning to everybody and welcome to our LinkedIn Live, which is also being simulcast on Facebook and on Twitter. We are here today with Dr. Elizabeth Hewitt Brumberg, who is a specialist in pediatrics and cardiology. And she is here to talk about a presentation she, recently committed to called Skills for Life: Teaching First Aid and CPR for Children. I'm Marie Manning. I work in marketing communications at the Red Cross and I will be your host for today. Please feel free. There's a comments box so you can feel free to put your comments, your questions, something about yourself into the comments box. I will be reading those and we'll be conveying those to Dr. Elizabeth Hewitt Brumberg as we go along in this session. So with that said, I'd like to introduce you all to Dr. Elizabeth Hewitt Brumberg and have you say, Dr. Elizabeth Hewitt Brumberg, can you give us a little bit about your background, where you're currently working, the work that you do, so on and so forth, so our viewers can get to know you a little bit better.
Sure. Hi, everybody. Thank you for joining us today. I am a pediatric emergency medicine specialist at UPMC Children's Hospital of Pittsburgh in Pittsburgh, Pennsylvania. I've been there for a little more than six years. I did my residency in pediatrics and my fellowship in pediatric emergency medicine at Boston Children's Hospital in Boston, Massachusetts. And I'm currently the vice chair of the first aid sub council for the scientific advisory council for the American Red Cross. And also, I'm helping to write the new joint first aid guidelines for the American Heart Association and the American Red Cross. So, I'm excited to be here today.
Between the Red Cross and your job, we keep you pretty busy, don't we?
Yes, yes. But the American Red Cross is a very worthy organization and I'm very happy to be volunteering some of my time to you guys, so.
That's great. I didn't know that you were helping to write the first aid guidelines. When can we, just a little offshoot question, when can we expect to have those come out?
So they should be published next November, so November 2024. So we're wrapping up kind of all the scientific information right now and writing it up. And then the next, I guess, 10 months, it'll be in editorial and getting ready for publication. And then it'll be out before Christmas next year.
Well, we may do another live on that. It actually would be perfect for our new science Twitter feed. Folks, if you haven't joined us on Twitter or X, as it is now called, it's at Red Cross Science. And we promote all the science that's being done by the Scientific Advisory Council, which is the backbone to our training. And they inform us about all of the latest science and make sure that our training is up to date. Okay, housekeeping is done.
Tell me what you're in pediatric emergency medicine. Tell us a little bit about what inspired you to talk about and about Skills for Life, about how children can learn first aid and CPR.
Yeah, so I think as a pediatrician and as a pediatric emergency medicine physician, you know, I interact with children and their families all day, every day. And I think children are often underestimated in terms of their ability to learn and retain skills and also their ability to really contribute to their families, their schools, their communities. And so, As part of work for the Scientific Advisory Council, we put together a position statement supporting first aid education for young children. And we're able actually to find a good amount of scientific data to support that, which kind of went along with my own sort of general gestalt of how amazing and capable children are to begin with. And so that was sort of what the start of this was. And then you know, with all of the amazing training work that the Red Cross is doing, you know, being able to think more about how we can apply that to children's education and make it accessible for a wide variety of the population was kind of an obvious next step. So that's kind of how this all came about.
Well, I know the Red Cross has done a lot of work in what we call our disaster services area, which is on preparedness. We have a program called Prepare with Pedro. There's another one called the Pillowcase Project that is being done in conjunction. It started in conjunction with Disney. and reach young children. So can you sort of take us through the different stages of children? You know, I know Pedro is earlier in the, you know, four, five, six range. Pillowcase Project is seven, eight, nine. And then of course we have First Aid for Severe Trauma, which is for high school students. So there's a different progression of learning. Can you give us some examples of that or walk us through it?
Yeah, so there have been a lot of studies, a lot of them out of Scandinavia, some of them out of the United States that have looked at the ability of kids to retain resuscitation and first aid skills. And starting as young as age four, kids have been able to show that they can assess somebody's level of consciousness to figure out and tell you appropriately whether or not they're breathing and then be able to tell you the correct emergency number to call. And then once they call that number, be able to give important information like the address where the problem is happening, which is basically what the EMS needs to be able to send somebody. And so that's kind of the starting point. for a lot of this education. And then by age six, they can operate an AED successfully and oftentimes do it better than adults because they follow directions, whereas adults do not. And then they can also sort of, they can show you how to provide correct compressions, the right rate. They often aren't strong enough at that point to provide the right depth, but they at least are kind of getting those sort of theoretical skills learned. And then kids as young as seven can actually effectively control hemorrhage after training. So, you know, long before high school, kids are able to really provide life-saving care that makes a huge difference in terms of outcomes in, you know, major trauma than out-of-hospital cardiac arrests.
Wow, I had no idea, as young as age four. And that's something it's because you just need to teach them 911, your home address, and then they, and have you, had any encounters like that? Have you heard of that in your work in the emergency department where young kids have jumped in to help an adult when they see them affected by something?
I don't care for a lot of adults just because I'm in the pediatric emergency department, but I will say we have a ton of siblings who recognize that there are issues with other siblings. And, you know, a lot of times it's a sibling that called 911, a sibling that found a child who was injured. And so, you know, I think those really are, you know, important contributions that they made to getting that, you know, their brother or sister or friend to appropriate medical care.
Wow. Now, one thing that came up that I know people are concerned about is adverse mental health consequences. Because, you know, these are kids. They're impressionable. You said that they do better at operating an AED than some adults do. And I can understand that because there's pictures. And you just follow the pictures on the AED. But... Can you explain, is there any truth in that or is it a misconception?
Yeah, so we were not able to find any data to suggest that there were poor outcomes from the first aid training or from resuscitation training. There really isn't a ton of data about people who actually intervene in something like a real out-of-hospital cardiac arrest or in a real, you know, major trauma situation. But I think the biggest concern people have is that kids may, if they do try to help and somebody has a bad outcome that they may somehow internalize that it's their fault. And I think there, you know, I think that that's a valid concern. I mean, kids are very sensitive to, you know, doing the right thing and wanting to help people and wanting to make sure that their actions don't hurt others. And so I think anybody who participates in something like that, whether it's an adult or a child, needs to get the appropriate sort of care, psychological care afterwards, because even an adult who helps in and out of hospital cardiac arrest, if that person doesn't make it, they may find, they may have some feelings that that may have been their fault and that they could have done something different or better. But I think in terms of the training aspect itself, there is good data to suggest that it actually improves empathy scores in kids. that it leads to more helping behaviors even outside of these first aid and resuscitation skills. And that also it may help decrease some risk taking behaviors in adolescents who sort of understand the consequences of more risky behavior. And so I think overall, the training aspect and the preparation aspect really provides a lot of good sort of emotional and psychological effects. And I think in a lot of ways, I think it's better to feel like you're prepared. I mean, I can't even imagine if you're 10 years old and you watch your grandfather collapse and you don't know what to do. I mean, I think that's a worse feeling than being able to call 911 and sort of knowing what the appropriate things are to assess and get grandpa to care.
Got it. Got it. You mentioned that, you know, one of the things we mentioned was training and a lot of training happens at schools. So what is the role of so we know that the teachers can do this, but what is the role of parents? Do they have any any role in this at all? Or is it strictly limited to school.
Yeah, so I think it depends a little bit on the family and the parent and what the parent's comfort level is. I think there are a couple ways that parents can be involved. I mean, certainly if they have instructor level training or experience in the healthcare field, I mean, I think volunteering in the school setting or at Girl Scouts or Boy Scouts or wherever this is being taught is really important because I think modeling that behavior by parents is important for kids to see. But I think there's also some evidence that kids actually go home and teach their family members the skills that they've learned in school. And so just being open to sort of hearing, you know, what that kid learned in school today. There are some home training kits that can be sent home from school. that kids can use to train other people in their family and community. And being receptive to that, I think, is also really important. And just generally being encouraging about the acquisition and demonstration of new skills and practice is important. So I think there are two different ways. I think you can sort of... help teach if you have the skills to do that. But I think just being a receptive learner is also important because it supports what your kid is learning.
Got it. Got it. We do have I want to remind everyone that you can put any questions you have for Dr. Elizabeth Hewett Brumberg into the chat box and we'll get to them. I want to circle back to something, Alan. Thank you for your question that Alan has asked, which you know, is there has there been any consideration that you know of in the studies for framing crisis situations differently for children to perhaps spare them from some mental some mental trauma? He writes, you know, wording matters.
Yeah, I agree. Wording does matter. And I think one of the advantages of having a lot of this education done in school, I think there are multiple advantages. I think it makes it especially availability in public school makes it available to a wide swath of the public, which is important. But I think it also, you know, teachers and school administrators are really the ones who know about kids' kind of knowledge acquisition levels, emotional sort of tolerance levels, emotional regulation levels. They know about them the best. And so, I think working with them to develop you know, scenarios and the best way to teach this is really important. And I think, you know, you need subject matter experts, but you also need kid experts. And I think teachers and school administrators are some of the best people to be able to do that.
So, you know, it's interesting that you talk about kid experts because that's some of your background. How when you're treating somebody in the ED,what are the differences between treating a child and then treating an adult aside from the fact that their physiology is extremely different?
Yeah. We do love to say that kids are not little adults, which is true in so many ways. But I think one of the hardest things about pediatrics is that, you know, kids of the same age can have very different emotional maturity levels. Like, and, and a lot of times, we need to rely on the parents to tell us kind of how much do you think they want to know. So, one of the things I often ask school age kids is, are you, are you a kid who likes to know a lot about what's going on, or a little bit about what's going on. And a lot of times they have enough insight to say, I don't really want to know that much. Or they'll say, I want to know every single little step and I want you to tell me exactly what's going to happen. And they often have the best insight and that they actually want. And so, you know, do occasionally make mistakes in terms of like, I've told you a little too much and now you're scared and upset. Yes. But I think we underestimate how much kids understand is going on. Like you cannot keep secrets from children. They know. So even if a parent wants to talk about something outside of the room, the kid knows that there's something going on. And so, trying to deliver that information in a way that is, that's, you know, appropriate for their age level is definitely a skill. And we in the emergency department, we have child life specialists who help us with that. And I think in the school setting, those are really the teachers that know the kids the best.
That's really interesting. We look at what schools are doing across the country. Some of it is we've seen a lot of success with getting mandates in states for teaching CPR and AEDs in schools. And some states, a few, not too many, are mandating now teaching bleeding control training in schools. What are your thoughts on not the politics of the mandates, but the idea that this needs to be a graduation requirement and that it's going to be taught by health teachers or gym teachers, physical fitness? What do you think about having this be a call to action in high schools?
I mean, I think it's incredibly important, actually. I think making this a requirement for public school graduation really provides kids with the skills and the knowledge that are necessary to be contributing members of society when it comes to things like injuries, cardiac arrests, those sorts of things. We know that in those situations, the first few minutes really matter and that you need to, if somebody collapses, you need a bystander to start CPR. And a lot of people do not get any sort of bystander intervention because people don't know what to do or they're afraid they're going to hurt somebody or they haven't had any training. And so having more and more people in the community who have had training really will increase the number of people who get training. help in those first few minutes before EMS arrives, which we know are some of the most critical, critical minutes. I mean, we know that, you know, five, almost five and a half percent of traumatic deaths could be prevented just by somebody opening an airway or providing hemorrhage control. And those people may not get that if there's no training for it. And so I think, you know mandates are always tough because it's like how are you going to pay for it and who's going to provide the training and how are we going to find the time in an existing curriculum but there is good data about you know this can be integrated into a school curriculum it can be taught by school teachers um it doesn't need to be done you know as huge amounts of time you know it can be you know an hour a week for a semester, you know, on an annual basis, just with kind of some intermittent retraining because we know that the skills do degrade over time. But I think it can, I think it's important. I think it's one of the more important things that we can teach kids. And so, and I think that making it widely available at no cost is really, really important intervention that will help both the kids that are graduating and then people who they may come in contact with later.
We have a question from Noreen and this is just trying to get your perception on something. When teaching an informational class for 9- and 10-year-olds, now let's assume that's CPR and AED. She's asking whether the adult mannequins should be used or really are appropriate and okay to use, even if they can't do the compression depth that you mentioned earlier and it's hard for them to do the skill.
Yeah, I mean, I think using... the adult mannequins because adults are generally who they're going to come in contact with who are going to need these interventions. I think that probably makes the most sense. There is information like using professional feedback mannequins often is more effective than using something else that's not quite as lifelike because the feedback gives you like you need to push harder, you need to push faster, and then being able to see the chest rise when you ventilate. And then I think also, but also sort of setting it up at the beginning, like, you know, we may not be strong enough to be able to do this and that's okay. We're just learning the skills right now. And, you know, next year we'll see how much bigger we've gotten and how much stronger we are. And I think those are, I think it's important to make it as lifelike as possible, but also to normalize the fact that this is a skill that you may not be able to do and that's okay. You know, we're just, we're learning the theoretical knowledge and then next year we're going to reinforce it again.
That's an interesting word, and I'm scribbling down. You use the word normalizing it. Tell me a little bit more. What is normalizing? Is that important for this age group?
Yeah. I mean, I think... Kids in general, nobody wants to be different with few exceptions. I think it's hard to be. And so I think framing it with most kids in our age group can't get the depth deep enough. And so, and saying, cause everybody wants to please their teacher too and saying, I don't expect you to be able to make the light turn green, but we're all going to try. We're going to see if we can get it fast enough. And, you know, to work on skills that they can achieve and then encourage them and say, you know, next year we're going to try again. And it's, you know, we'll see how much better we've gotten. And so I think just making sure that it's not a failure situation, that it's a we're going to keep working on it situation. And this is what I expected today. And you guys did great. You know, so making it a really positive experience. And kids love hands on things. Yeah. Yeah. To practice stuff is important.
Okay. Well, what are, as we look to wrap this up, what are, what would you say are basic skills every kid should know? And let's break it down into age groups. So let's start with really young kids. You mentioned four years old. So, what should a four or five-year-old, maybe a six-year-old know about first aid and CED?
Yeah. I mean, I think a young kid should know that if they live in the United States, 911 is the emergency number. And you should be able to ask them, who do you call for help? And they should be able to say 911. They should know what their home address is. That's really important. And they should know what their school's name is or where they spend the day. And they don't necessarily need to know that address, I don't think. And then just reaching out kind of more into disaster preparedness, like preparing with Pedro, et cetera. Things like what their parent's full name is. That's really important because if you ask a four-year-old what their mom's name is, they might tell you mom. And that is not... And so really, you know, tell it really, you know, my mother's name is so-and-so, and her phone number is this. Those are also really important skills. And then I think also just like the initial assessment, is that this person breathing? Are they conscious? Are they talking to me? They're pretty good at that. And then, yeah, They also may be able to maneuver somebody's head to put it into like sort of the right airway positioning. And then kids actually as young as four work together to get adults into a recovery position. And so I think that's also something that you can teach along with the teamwork associated with that. And then as you, so that's sort of the basics for the youngest age group. And then as they get older, you know, as you're talking about like the six, seven, eight year old, they should be able to know that in order to get an AED to work, you turn it on first and then you follow what it is that it tells you to do. And then, you know, they can start to learn the skills of chest compressions and ventilation. They can, you know, learn that you need to put pressure on like a little bleeding scratch and then you should, you know, wash it and put it on. put a band-aid on it. And then I think, you know, as they, as you get older into late elementary school, middle school, high school, those are the kids who can start learning about tourniquet application, pressure for bleeding, those sorts of skills, and kind of layering things on top. But I think as you start adding complexity, you also need to reinforce the initial skills, sort of every time you teach new skills, so that, because everything, all this training, the first aid training, the resuscitation training, all layers on itself, And so reinforcing that going forward is really important.
Right. Because I think, you know, there's data that shows that you do forget. You don't remember everything.
Yes. And there is a time frame for forgetting. I think what I'm hearing you say is, you know, it should probably be done once a year.
Yeah. If that's possible, if it's possible. And there's good data for annual training, especially for the first three years. And then after that, you may be able to space it out a little bit more, but you should. But yeah, annual training is important, at least in the beginning.
Good. Okay. Well, I don't see any more questions in the chat box. So let me just make sure I got everything. Yep, we did. And thank you to everybody who came. Is there anything, Dr. Huett-Bromberg, is there anything that we should have talked about that comes to your mind, a story from the ED that you feel is important? What would you like to leave us with your last words?
I think I would just like to say that this idea of teaching kids first aid is actually supported by a variety of different organizations. It's not just the Red Cross who's out here preaching this, but the American Academy of Pediatrics, the International Federation of the Red Cross and Red Crescent, the International Liaison Committee on Resuscitation did a review recently that was published in July. And so, you know, everybody is sort of starting to recognize how amazing kids are and how they can learn these skills and really apply them in real life. And so I think, yeah, I think it's just really important for people to be advocates in their community for education like this that's accessible to everybody, whether it be in schools or in organizations like church groups and for Boy Scouts and Girl Scouts and whatever else kids are doing. So I just think these are such important life skills that we should be providing our youth.
Agree, agree. We are so glad to have you come on and talk about this. I've gotten some very positive feedback here in the chat and really appreciate your time today. So thank you very much.
Thank you very much. I've really enjoyed being with you guys. So I hope you have an excellent rest of your day. Thank you.
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