Most of us look forward to family get-togethers and celebrations, never thinking that the happiness of such good times could be stolen in an instant. But that’s what almost happened to Amy Steelman and her two-year-old, Hannah, at a birthday party for Amy’s grandmother in Norman, Okla. in August, 2010.

Both Amy and Hannah were eager to reconnect with family, and all of the kids quickly ran out of sight and earshot.

“I had a sinking feeling when I couldn’t find her,” Amy said, thinking of her grandmother’s above-ground pool in the backyard. She ran outside and saw Hannah and a cousin floating face down in the water.

In Amy’s panic, she first tried a couple of breaths but they didn’t work. Her cousin suggested compressions. Thanks to CPR, both little girls survived.

Can you tell us what you did?
I started the compressions. It only took one round, and she started coughing and vomiting. She was crying, and she had this faraway look in her eyes. It was so scary.

How in the world did you stay calm?

I knew I had to do something. In my senior year of high school, I did a nursing option program, and I learned CPR. I just knew I had to save my daughter. I think I had this feeling that I just had to be strong, that I really had to keep it all together.

How did Hannah react to all of this?

When they put us in the ambulance, they would not let me in the back with her. I could hear her crying from the front, and I think she could hear my voice. She was crying for me, so it was really hard. I just kept trying to talk to her so she could hear me.

Later, she didn’t remember what happened. All she said was that she went swimming and then she went ‘night night.’  It broke my heart.

How is Hannah now?

Hannah is great! She just learned Hands-Only CPR through her Girl Scout troop. I’m her troop leader, and I brought in some CPR trainers from Tulsa. It was very emotional. When the class started, I cried, just watching her listen to the instructor and thinking of how CPR had saved her life that day years ago. And now, she’ll be in the position to save someone else’s life.

And how about you?

I tell everyone I know — parents, grandparents, babysitters — that everyone needs to know CPR.  We wouldn’t have Hannah if it weren’t for Hands-Only CPR. I thank God I knew CPR. wouldn’t have my Hannah without it.

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More than 7,000 children suffer an out-of-hospital cardiac arrest annually. Parents and caregivers are among the most important people to be trained in infant CPR, which can make a life or death difference. The American Heart Association’s Infant CPR Anytime Training Kit allows anyone to learn the lifesaving skills of infant CPR and choking relief  in less than 20 minutes from the comfort of their home or workplace.

How does a medical professional take skills learned in the field and translate them into a new career? One path forward is entrepreneurship. Today the CPR & First Aid Blog talks with Josh Dishaw, founder of RESTART in Middlebury, Vermont. 

Q: Josh, thank you for speaking with us. Would you start by sharing a little about your background?

A: Of course. I started by getting my undergrad degree in geology, which was a terrible idea! I then joined my local volunteer fire department when I was 21. I moved into EMS from there and spent the better part of 18 years as a pre-hospital medic.

For the past five years, my full-time job has been teaching Advanced Cardiovascular Life Support (ACLS), Pediatric Advance Life Support (PALS), and more. My business contracts these education services out to hospitals, bringing high-quality Association education to hospital staff.

Q: What inspired you to switch from working as a medic to owner-operator of a training company?

A: I love a challenge, and I felt that I had reached the highest point I could go in EMS. I didn’t want to have to fight feelings of complacency in my work.

I knew I wanted to do something different, but I also wanted to keep helping people. So I returned to school in 2010 and earned my master’s degree in education. That degree helped me conceive of my business, where I marry classroom education with healthcare.

Q: You have a unique approach to training. Would you tell us more?

A: I went to a non-traditional education program, and it taught me that every person in a classroom is going to learn in their own unique way.

Knowing that, in my program I take AHA’s instruction material and lay the information out for everyone to embrace in their own way. I then use open-ended questions to get everyone talking and working as a team. The important technique here is to use what comes naturally.

For example, when discussing a technique, I ask the class “why this method?” Someone typically responds, but usually only gives part of the answer. I take that and ask the classroom to elaborate. Soon we have everyone talking and the class has figured out the right answer without my having to do much one-way lecturing.

Q: What do you view as the key to your continued growth and success?

A: It goes back to fighting complacency. When you stop being a student yourself, you’re going to get stuck. Be receptive to new techniques and ideas.

Q: What would you advise to others who also want to expand their careers?

A: Keep an open mind and look for a niche you would like to be involved in. It’s tough, particularly when you want to do something familiar in a new way. You need grit, and you need to get out there and talk to people. If you have a good product, get it out there and let word-of-mouth work for you.

Emma Baker was 13 and eight days into a New Year’s resolution she’d made not to spring things on her parents at the last minute.

Her mother, Cate, was on a business trip to Atlanta from their home in Rose Hill, Kansas, so Emma called her dad, Scott, for permission to go to a spelling bee in nearby Buhler on Jan. 8, 2013.

Within hours of getting to Buhler, excitement almost ended Emma’s life. No one knew that she had a rare heart condition called Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT). Patients who have CPVT have mutations or faulty changes in that gene, CASQ2, and that causes a cascade of reactions, including abnormal heart cell communication and structural problems with the heart.

In Emma’s case, adrenaline triggers her heart to beat irregularly, and she went into cardiac arrest. Had it not been for a mother in the crowd who knew Hands-Only CPR, Emma likely would not have lived.

“We owe it to everyone to try to help everybody learn CPR,” said Scott. “We’re so blessed, and we’re not gonna let that blessing go unanswered.”

The American Heart Association is working hard to do its part, too.  Its CPR in Schools Training Kit enables as many as 20 students at a time to learn lifesaving CPR skills in one class period. With 38 states and the District of Columbia now making CPR training a requirement for high school graduation, the kit is an important way to train more than two million students each year. Teachers and other staff also can be trained.

Cate will never forget when the school’s vice principal called. . “He said, ‘there’s been an incident.’ I thought, ‘What did Emma do?’ But he said, no, it was serious, that Emma wasn’t breathing.”

Scottgot word and raced to Buhler. When he drove up to the hospital, he saw a helicopter with blades whirling and Emma being wheeled toward it on a gurney.  A nurse told him that they were taking Emma to a Wichita hospital. As he drove to Wichita, Cate was boarding a plane from Atlanta.

Cardiac arrest survivor Emma Baker, an advocate for Hands-Only CPR, speaks with her parents at AHA’s annual Go Red for Women luncheon in Kansas.

But once Cate and Scott were at the hospital, they still had no answers – and possibly more bad news to come. Doctors said they did not know if Emma would live and, if she did, whether she might have brain damage.

As it turns out, Emma survived with few lasting effects and a fairly quick recovery. Within four days, doctors removed her breathing tube. And while she had short-term memory loss, she eventually regained it. Had the mom in the crowd not been there to start Hands-Only CPR right away, Emma would have had a greater chance of dying.

The Bakers have become fierce advocates of Hands-Only CPR, teaching at schools, festivals and other gatherings.

“The thing that her dad and I took away is that if this had happened in our living room, we wouldn’t have known what to do,” said Cate. Now that they do, they want to make sure others do, too.

People who perform CPR most likely will be trying to save the life of someone they love, as most out-of-hospital cardiac arrests happen in residential settings. One of the great benefits of the CPR in Schools Training Kit is that it increases the number of people who can save a life anywhere.  Every student, teacher or staff member who learns CPR from the CPR in Schools Training Kit could also become a lifesaver at home.

February is Heart Month, a time when we recognize that cardiovascular disease kills 2,200 Americans each day, and more than 900 of these die from out-of-hospital cardiac arrest. The American Heart Association trained more than 22 million people in CPR last year, but few ever think, “That could be me.”

Even the Association’s own Krisca Gould, a CPR in Schools manager promoting CPR education in  schools at AHA’s Midwest affiliate, didn’t think she would ever find herself performing CPR outside of a classroom. So when that panicked call from her mother came in, Krisca found herself stunned as she raced to save her father’s life.

Krisca, thank you for sharing your story. Tell us what happened. 

The Gould family got to say goodbye to their loved one thanks to CPR.

My father had a history of heart issues, including Type 2 diabetes. In November, he suffered cardiac arrest at the age of 76. Despite my advice to always call 9-1-1 first, my frightened mother called me. Thankfully, I was close and dashed over. I moved my dad to the floor, and then I performed chest compressions while my mom called 9-1-1. We worked until Emergency Medical Services (EMS) arrived.

EMS and the hospital doctors stabilized my dad, and he woke-up and was coherent for a short time. Because of that, we had one last chance to be a family – to sing, laugh and say goodbye. If I hadn’t been there to perform CPR, we wouldn’t have had that chance. He sadly passed away a week later from renal failure.

What lessons would you want to impart from what happened?

The first is to take this seriously. Nobody thinks they’ll be called upon to respond to a cardiac arrest; it’s always somebody else. I read it in the newspaper. I heard it from a friend. No one ever believes it will happen to their family, but it does.

I’m that statistic now. Since my dad’s cardiac arrest happened, my sister and my children have all taken a CPR class – and taken it seriously. A class is great because you learn technique and memorize the steps so that you can perform them on autopilot, because in the moment things can feel overwhelming.

The most important thing is to call 9-1-1, then push hard and fast in the center of the chest. If nothing else, this is what you should remember. For every one minute without CPR, the chance of death increases by 10%.  Emergency medical services take on average between four and ten minutes to reach someone in cardiac arrest. If the first person on the scene, which is typically a loved one, performs CPR prior to first responders’ arrival, that person will dramatically increase the victim’s chances of survival.

Do you have any final thoughts?

Learn CPR! Drivers buy car insurance; homeowners insure against disasters. Why doesn’t everyone have this insurance that could be the difference between life and death? My last thought is that the living survive better if they took action. There is less guilt, fewer “what ifs.” If you won’t do it for others, do it for yourself. You might need it.

Hit rewind and watch the highlights of the 2017 Anthem Foundation and American Heart Association Hands-Only CPR campaign.

David Heidrich had never heard of Hands-Only CPR until August when the American Heart Association’s 2017 Hands-Only CPR Mobile Tour stopped in Augusta, Maine to teach the lifesaving skill.

“Push Hard and Fast in the Center of the Chest” is the second step of Hands-Only CPR that was depicted in a Hands-Only CPR PSA that featured actress and comedian, Wendi McLendon-Covey, in 2017.

Hands-Only CPR has two steps, performed in this order: when you see a teen or adult suddenly collapse, call 911. Then, push hard and fast in the center of the chest until help arrives.

Heidrich was trained in Hands-Only CPR and, as a future lifesaver,  understands how critical it can be for bystanders to respond if they witness a cardiac arrest outside the hospital.

“The chest compressions you apply while administering Hands-Only CPR can be vital to buying the time necessary to allow emergency medical personnel to arrive at your location,” said Heidrich, who is the director of communications for the State of Maine’s Department of Administrative and Financial Service.

The crowd practices compressions in order to do Hands-Only CPR at the Hands-Only CPR Mobile Tour stop at the North Lexington Family YMCA in Lexington, KY in Sept. 2017.

More than 3,700 people were ultimately trained in Hands-Only CPR during the six-week long 2017 tour, making it one of the highlights of the 2017 American Heart Association Hands-Only CPR campaign. The campaign is nationally supported by a five-year, educational grant from Anthem Foundation.

The campaign aims to increase the survival of cardiac arrest victims outside the hospital by making the public aware of Hands-Only CPR, training people in Hands-Only CPR and AED use, and giving people the confidence to take action. The interactive Mobile Tour is one way that the American Heart Association and Anthem Foundation meet people where they’re at with critical instruction and education.

Heidrich relished the opportunity to use an AED, or automated external defibrillator, training device for the first time at the tour stop.

“It seems like they (AEDs) are everywhere now – from malls and airports to workplaces and schools – and having the opportunity to use one in a non-emergency situation made me feel better about using an AED when it really counts,” he said.

A traveler practices Hands-Only CPR on the interactive training kiosk in Aug. 2017 at Cincinnati-Northern Kentucky International Airport.

In addition to the tour, the American Heart Association and Anthem Foundation continued to provide Hands-Only CPR training to the public in innovative ways. The organizations placed more Hands-Only CPR training kiosks at various U.S. airports.

The two organizations also teamed up with actress and comedian Wendi McLendon-Covey to create a humorous Hands-Only CPR training PSA called “The Mix Up” that was shown on cable TV networks and elevator screens in lobbies of buildings in various U.S. cities. You could even watch this memorable PSA and learn Hands-Only CPR while in the air on Southwest Airlines, which displayed the piece on its in-flight WiFi portal for nearly two months in November and December.

The Association and Anthem Foundation are ready to reach many more Americans with this lifesaving skill in 2018.

Evelyn Massey, MD, teaches CPR to local students and school faculty.

Readers of the AHA CPR & First Aid Blog are no strangers to teaching CPR. However, few focus almost exclusively on the next generation of lifesavers like Evelyn Massey, MD, does.

Dr. Massey serves as director of life support education at Loma Linda University in California, where she administers a program that aims to train 50,000 high school, college and community students in CPR by 2020. Currently, she has trained 7,000+ students and counting.

“We start with the basics of ‘what is a heart attack, and how is it different than cardiac arrest? and then teach the skills required to handle a cardiac arrest situation in real life,” explains Dr. Massey. “This starts with promoting awareness in elementary school and beyond. We begin simple with Hands-Only CPR (HOCPR) with middle school, and then work with the teenagers in high school on more advanced programs.”

The motivations for Dr. Massey’s work are personal. Her father passed away from cardiovascular complications when he was only 58 – far too young and too soon. Her work is fueled by the desire to train others so that no one else loses a loved one that could have been saved.

“Today I work in administration, but by doing so I’m able to save lives. Schools are an incredibly important – and in some communities, underserved – target,” continues Dr. Massey. “For instance, one of our high school trainees came home one day to find her father face down on the floor, suffering cardiac arrest. She called 9-1-1 and started chest compressions. She continued for 20 minutes without pausing, and today her father is alive and well.

“This girl is a hero, all because she had been given the emergency training she needed while at school.”

The minutes before even EMS arrives matter the most. Most often, if a patient is brought to the hospital without having received compressions, it will be too late.

Students learning CPR at a local course offered by AHA Instructor Evelyn Massey, MD.

So why teach children?

“Because they’re everywhere!” exclaims Dr. Massey. “Someone at school, the mall, church or anywhere can collapse. Youth are often the only ones present – especially among peer groups – and they need to be able to act until EMS arrives.”

Not unexpected, her work has inspired a spike in interest in medicine as a career by providing students a practical introduction. Moreover, Dr. Massey is grateful to the state of California for some help in this regard—and to the AHA for their efforts to expand CPR in Schools education legislation across the United States.

“California requires high school students pursuing medicine to be trained in CPR and for schools teaching health education to offer CPR training,” says Dr. Massey. “It is a good law, but we should expand it. I would like to see kids choosing medical fields to receive more advanced medical and first aid training, and for all students to have the basics in Hands-Only CPR.

“It is a life-saving skill for everyone to know.”

The remote town of Waterville Valley, New Hampshire seems like a movie setting. It’s a picturesque New England village, home to world class ski slopes and a local high school dedicated to training the next generation of Olympic skiers.

Working outside is standard practice for Waterville Valley, in the heart of New Hampshire’s ski country. Here, AHA Instructor Jeff Dropkin oversees CPR training.

And just like in the movies, the setting wouldn’t be complete without someone behind-the-scenes, working hard to ensure that this dream doesn’t become a nightmare. That someone is Jeff Dropkin, paramedic and captain of the local fire department, who also teaches the American Heart Association’s ACLS, PALS and PEARS courses at nearby Speare Memorial Hospital in Plymouth, NH.

The same snowy slopes that give Waterville Valley its charm also pose hidden dangers. From cardiac arrest to head trauma, it’s Jeff’s job to ensure that everyone in the community – from the ski patrol to the teachers to the bystanders – have the skills they need to recognize and react at a moment’s notice.

“We’ve seen several instances where the athletic exertion and the deep snow cause sudden cardiac deaths,” shares Dropkin. “Moreover, they’ve added more dangerous features to ski resorts now, and we’re seeing a lot more injuries than we used to. Often, you have to make the correct treatment decision within seconds.”

In recent years, the State of New Hampshire has pushed hard to raise its standards of cardiac medicine, including changing statewide protocols to make high-quality CPR, with a focus on teamwork, the standard for EMS responders.

“Bystanders start by calling 9-1-1, then immediately begin either CPR with rescue breaths or Hands-Only CPR. You never break for more than 3 seconds. You deploy the AED as soon as you can. You also do chest compressions in between the AED shocks when the machine recharges. EMS responders don’t stop CPR for anything, not even when we put in the IV. No breaks. This is how people get saved – immediat e, constant CPR and immediate defibrillation in a shockable rhythm.”

AHA Instructor Jeff Dropkin oversees a community CPR training. To the right of the photo is a rescue sled, a necessary piece of equipment in this ski community.

One life that Jeff remembers saving is a cardiac arrest victim that you would least expect: a 14-year-old boy at snowboard practice. However, tragedy was averted thanks to what the AHA calls the “Chain of Survival.”

Young Will Bayha’s team coaches had received a CPR refresh training by Dropkin only six months before, and knew the signs when the boy went into cardiac arrest. One coach started CPR immediately while the other ran for the AED and called 9-1-1. They had the AED deployed in 90 seconds. Dropkin and his EMS team arrived a minute later.

In the ambulance, Dropkin evaluated and then supported the boy with O2, capnography, cardiac monitoring and serial EKGs. They continued support with respirations and fluid resuscitation as Dartmouth Hitchcock Air Rescue arrived to airlift the young man to a hospital where he was fitted with a pacemaker. Today, he’s fine. And even though he’ll never snowboard competitively again, he still hits the slopes for fun.

A happy ending, thanks to an unfailing commitment to high-quality CPR for both bystanders and professionals alike.

Janice Morgan is the coordinator of the Louisville Metro EMS Training Center, which spreads across 80+ sites with more than 1,500 Instructors. She is an AHA Hands-Only CPR Instructor, a passionate advocate of improving CPR training for both medical professionals and the public at-large, and seeks to make Kentucky a national leader in adoption of RQI for first responders. 

Janice Morgan (holding manikin) and her team at Louisville Metro EMS Training Center

Ms. Morgan, thank you for talking with us. Would you give us your background?

I began my career as a paramedic with Jefferson County (KY) EMS, now Louisville Metro EMS. I accepted the position of Louisville Metro EMS Training Center Coordinator in 2012.

In your current role, is there an initiative you’re particularly proud of?

Through a partnership with the Kentucky Refugee Ministries, Catholic Charities USA and Americana World Community Centers, we’ve undertaken an intense effort to train refugees relocated into Kentucky in Hands-Only CPR (HOCPR). We are also working with a grant project funded through Jewish Foundation of Louisville to distribute CPR kits and train people in underserved areas, including but not limited to refugees.

Through the HOCPR program, we train these communities in how to save a life. It can be difficult for those who don’t speak English well to communicate with 911 operators, so it’s important to us – from an EMS standpoint – for them to know and perform the necessary steps that will help a potential cardiac arrest victim. Nepali, Kurdish, Farsi, Congolese…those are just a few of the 28 native tongues we have worked with.

In addition to community-based CPR training, you’re a big advocate of American Heart Association’s Resuscitation Quality Improvement (RQI). Tell me more.

We really want RQI in Louisville. Our training center has joined forces with the Louisville Police and Fire Departments to consider implementing the program and possibly share the investment cost.

RQI is in about 200+ U.S. hospitals, but only two out-of-hospital systems currently employ it. I’d like to make Louisville a national leader in RQI pre-hospital training; it could make a difference in saving lives.

For our readers who may be unfamiliar, would you describe RQI for us?

AHA’s RQI program centers around CPR training performed on an automated manikin that records and tracks your progress. You complete a few minutes of compressions on the manikin quarterly as opposed to undertaking a bi-annual certification. The benefits are that you refresh your skills frequently, get instant feedback from the computer, and receive regular extensions on your certification as opposed to having these long gaps between trainings. Even better, the manikins would be conveniently located throughout Louisville for quick and easy use by our contributing departments.

The program in particular helps medical practitioners who may not use CPR on a regular basis, such as a psychiatric nurse or dentist, but who still need or want the training.  It keeps their skills sharp and the knowledge forefront.

And what of the system’s impact on Instructors like you?

I’m a huge fan of the system, obviously. It keeps skills fresh and removes human subjectivity by standardizing the procedure. That said, it doesn’t eliminate the need for professional Instructors. Someone still needs to conduct the initial training. Someone needs to oversee the computers. And someone needs to be available should the manikin break or computers experience a glitch.

In short, RQI is one more tool in our arsenal to promote quality, consistent CPR training.

AHA Instructor Hannah Jamsay

In advance of World Heart Day (September 29), we welcome a guest piece from Hannah Jamsay, CEO and Executive Director of Uplift Internationale (UI) and an AHA Instructor. UI is a Denver, CO based non-profit specializing in bringing life-changing facial reconstructive surgeries to impoverished children in the Philippines.

Living in America warps your perception.

I don’t mean that in a bad way, more that we’re so blessed with abundance that many of the things we take for granted as common practice are – in other parts of the world – life changing revelations.

Over the last nine years, I’ve had the pleasure of volunteering for Uplift Internationale, and for which I have served as executive director since May of 2016. UI’s mission is to provide poor children in rural villages of the Philippines with life-changing surgeries such as cleft palate repair. A nurse by training, I’ve also served as a BLS Instructor and have led Hands-Only CPR awareness events and classes on behalf of the AHA for almost eight years. On UI’s most recent trip, I decided it would be cool to introduce CPR training alongside our surgical work. I wasn’t sure what to expect, but the results blew me away.

Medical care, particularly in these rural communities, isn’t like here. Healthcare workers will wash and reuse several one-time-use, disposable pieces of medical equipment. Hospital patients are grouped into large rooms together, and it is incumbent on a patient’s loved ones to handle all of their personal care (bathroom, feeding, etc.) Upon arrival of my first mission, I found myself scrambling to find cots so that our post-operation children wouldn’t be spending their recovery on a dirty concrete floor.

Teaching Hands-Only CPR in the Phillipines

Here, even some trained healthcare workers have never learned CPR.

When we arrived in the Philippines this past year, the locals were wary of us – as they usually are. If you’ve ever had the opportunity to work with Filipinos before, you know that this is a reserved (but extraordinarily appreciative) culture.

Who are these people and why are they wanting us to beat our hands on someone’s chest?!

However, it wasn’t long before I had sat down with enough families and health workers one-on-one to earn their trust. It’s amazing the goodwill a few toys and teddy bears can buy you. And that’s when we saw the amazing happen.

There is such a craving for good healthcare knowledge in these parts of the world that all it took was a spark, and suddenly we had the entire communal area full of willing participants in a Family & Friends®

CPR training.

Almost two dozen got on the floor and learned how to give chest compressions on the manikins, which had been donated by Colorado Advanced Life Support and Children’s Hospital Colorado. Many more eagerly observed. What was originally planned to be a short demonstration turned into an hours-long event where we reviewed different CPR techniques, chest compressions for infants, and first aid for universal emergencies such as choking.

At the end, when we donated the manikins to the village so that they could continue to practice and teach others what they had learned, leaders within this typically shy and timid culture couldn’t hold it in – they wept in joy and in gratitude.

It was such a small thing for us. But for them, it was the ability to save a life.

Editor’s note: Based on the success of this first experience, Uplift Internationale is now committed to teaching CPR as part of its work alongside performing facial surgeries for indigent children. Its next mission trip is scheduled for February 2018.