(CNN)When someone calls 911, the time it takes for paramedics to arrive can be the difference between life and death.
Telephone CPR could save lives, but only a handful of states require 911 operators to be trained for it
Minnesota lawmaker Julie Sandstede knows this. She represents a rural area, where ambulances may take longer to arrive on the scene of a medical emergency.
When her husband experienced cardiac arrest in 2011, the dispatcher sent the ambulance the wrong way. Luckily, he was saved by a bystander who performed CPR on him under the guidance of a 911 operator.
"(The operator) was able to assess the situation and give direction to what intervention was needed," Sandstede said. "We were so fortunate."
Her husband, Evan Sandstede, was lucky to have an operator who knew how to walk someone through CPR. But that's not always the case.
"When I learned that not all 911 operators are trained in how to instruct CPR over the phone, I couldn't believe it," Sandstede said. "I was shocked. ... This is unconscionable."
This legislative session, the Democratic lawmaker has proposed legislation in Minnesota that would require all 911 operators to be trained in telephone CPR.
Telephone CPR is the process in which a 911 operator helps the caller identify cardiac arrest with a short script and provides "just-in-time" instructions on how to provide CPR, said Dr. Michael Kurz, chairman of the American Heart Association's Telecommunicator-CPR Task Force.
Sandstede proposed the bill after she was approached by the American Heart Association, which has been lobbying for these kinds of laws nationwide.
At least six states already require 911 operators to be trained in telephone CPR, according to the American Heart Association. They are Louisiana, Kentucky, Wisconsin, Indiana, West Virginia and Maryland.
However, the American Heart Association has been lobbying for all states to adopt telephone CPR requirements. The organization said it would be a cost-effective way to increase the survival rates of people who experience cardiac arrest outside a hospital.
Widespread implementation of telephone CPR would include three to four hours of initial training and a yearly refresher, said Kurz.
"When we talk about public health interventions, this is a relatively low-cost, very high-yield way to improve public health," he said.
Sandstede said her bill is modeled after Wisconsin's law, which was enacted in 2018 and set aside $250,000 for telephone CPR training.
About 350,000 sudden cardiac-arrest events occur in the United States each year, and survival rates nationwide average about 10%, Kurz said.
A 2018 Cleveland Clinic survey found that 54% of Americans say they know how to perform CPR. However, only 11% of respondents knew the correct pace for performing the chest compressions, the survey found.
Having a bystander provide CPR before paramedics arrive on the scene can double or even triple the rate of survival, Kurz said. Telephone CPR-trained 911 operators can identify whether someone is going into cardiac arrest with two questions, and can provide CPR instructions in about 20 seconds.
"The public largely assumes that if you call 911, you'll receive instructions on whatever the medical emergency is," Kurz added. "In reality, we know that there's a very large disconnect."
Some people think that telephone CPR is equivalent to practicing medicine and only physicians who are licensed should do that. However, Kurz said that is a misconception that is hindering public health.