The NCSL Blog


By Mia Geoly

Out-of-hospital cardiac arrest incidents rose during the COVID-19 public health emergency in large cities.

Man performing CPR. Credit University of Minnesota. herraez / iStockLawmakers in five states—Virginia, Oklahoma, Rhode Island, Texas and Indiana—enacted legislation in 2021 establishing a training requirement for 911 dispatchers to learn telephone cardiopulmonary resuscitation (T-CPR).

During T-CPR, a telecommunicator delivers instant CPR instructions to a caller in order to keep the heart and brain alive before EMS can deliver other vital interventions.

Few 911 calls for cardiac arrest cases may actually receive CPR instructions, and some callers are instructed to wait until help arrives.

Research shows T-CPR is an effective way to ensure that CPR is administered prior the arrival of emergency medical services, providing someone experiencing cardiac arrest a two to three-fold higher likelihood of survival. 

The practice of T-CPR originates from a 911 call made in 1974 requesting help for a drowning child in which the dispatcher gave the phone to the responding medic, Bill Toon, who gave the caller a crash course in CPR to keep the toddler alive until EMS intervention.

The event led to some standardization of care in emergency dispatching. The National Highway Traffic Safety Administration also created CPR LifeLinks, an initiative aiming to draw attention to the issue and providing a CPR program implementation toolkit for EMS and 911 services nationwide.

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Mia Geoly is an intern in NCSL’s Transportation Program.

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About the NCSL Blog

This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.