Sudden cardiac arrest (SCA) kills over 900 adults each day in the USA. That is about 335,000 of the 550,000 annual deaths from coronary heart disease. The main cause of death from SCA is brain cell death from lack of oxygen. Brain death usually begins in four minutes and is usually complete in less than 10 minutes. Cardiopulmonary resuscitation (CPR) supplies some oxygen to the brain, delaying the death of the cells. Immediately applying CPR can double a person’s chance of surviving SCA, and the sooner CPR is started, the greater the chance of survival. That is why, starting next year, all 11th grade students in Iowa will go through CPR certification as part of their PE classes. The new CPR training is part of the Healthy Kids Act, which was was passed by the 2008 Iowa legislature. According to the Iowa Department of Education, "The purpose of the Healthy Kids Act is to establish physical activity requirements for students in kindergarten through 12th grade and to establish nutritional content standards for food and beverages sold on or provided on school grounds during the school day." The Healthy Kids Act lays out the basic rule that the CPR training must be completed before a student can graduate. It also includes guidelines for nutrition and other items that will go into effect in upcoming years. Some students have questioned whether a previous certification will excuse them from PE, or from the CPR section. The Healthy Kids Act states that "a school or school district shall accept certification from any nationally recognized course in cardiopulmonary resuscitation as evidence that this requirement has been met by a pupil." But this will not get the student out of any activities. "If a student is already CPR certified, they could take [Modern] dance if they wanted to," said associate principal Mike Avise. "If they are previously certified, they will have options; they can help others during the training or do alternate exercises." "What the class will entail is still being worked out," Avise said. "But the class will lead to some type of CPR certification. Infant and baby CPR will not be included. Since we have all of the [emergency defibrillators] hanging up in the school it would make sense to include how to use them." In cities like Seattle on the west coast, where CPR training is widespread, survival rate from witnessed cardiac arrest is about 30 percent. In New York City, where few people receive bystander CPR, the survival rate is around 1 percent. Hopefully, the new CPR training for Iowa students will increase the survival rate in Iowa and save many lives.