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Saving Lives: Why CPR AED Training Matter

None of us expect the unexpected. With 10,000 cardiac arrests in the workplace every year, you should understand the benefits of CPR training.

By Gina Mayfield

When it comes to ensuring safe and healthful work conditions, we tend to focus on finding and fixing commonly recognized hazards such as clearly preventable injuries and illnesses. While these dangers certainly warrant our attention, what about expecting the unexpected, such as an employee experiencing a cardiac arrest outside the hospital? Is your workplace fully prepared for an incident that requires CPR or even a defibrillator?

June is CPR Awareness Month, with the first few days designated as National CPR and AED Awareness Week. Both occasions were designed to bring attention to the importance of CPR and AED training that organizations can provide to keep their employees safe, prepared to respond and…alive. Trained employees who can properly and quickly respond to an out-of-hospital cardiac arrest before emergency responders arrive can help save a life.

Cardiac arrest—an electrical malfunction in the heart that causes an irregular heartbeat (arrhythmia) and disrupts the flow of blood to the brain, lungs and other organs—is a leading cause of death. Each year, more than 350,000 EMS-assessed out-of-hospital cardiac arrests occur in the United States, according to the American Heart Association (AHA).

Be Ready: CPR

When a person has an out-of-hospital cardiac arrest, survival depends on immediately receiving CPR from someone nearby.

According to the AHA, about 90 percent of people who suffer out-of-hospital cardiac arrests die. CPR, especially if performed immediately, can double or triple a cardiac arrest victim’s chance of survival.

But most U.S. employees are not prepared to handle cardiac emergencies at work because they simply lack the training, according to findings from two surveys from AHA as part of its Workplace Safety Training Initiative. Between February and April 2017, researchers surveyed 2,000 employees in various fields such as corporate offices, hospitality, education and industry/labor.

Study findings revealed that most employees do not have access to CPR and first aid training, and half could not locate an automated external defibrillator (AED) at work (helpful hint: place it in the same location as the fire extinguisher). Such training has the potential to save thousands of lives, considering there are 10,000 cardiac arrests in the workplace annually.

The second survey from OSHA and commissioned by AHA included more than 1,000 safety managers in industries regulated by OSHA. The safety managers see a need for more frequent training, but a third of them said first aid, CPR and AED training only become a priority at their workplace after a demonstrated need, meaning after an incident.

All of this data brings to light an important realization: Employees may be relying on untrained peers in the event of an emergency, which creates a false sense of security. Many may wrongly believe there is someone onsite who is qualified and able to respond, but that’s clearly not always the case.

Here’s the good news: The study shows that more than 90 percent of employees would take First Aid and CPR+AED training if employers offered it.

Save Lives: AED Awareness

Use of an AED is the third step in the cardiac arrest chain of survival, with the first two steps being a call to 9-1-1 and beginning immediate CPR.

During a cardiac arrest, the electrical activity in the heart is disrupted. According to the AHA, every second counts because without immediate CPR, the heart, brain and other vital organs aren’t receiving enough oxygenated blood. For every minute without CPR, the chance of death increases by 10 percent.

Survival from cardiac arrest doubles when a bystander applies an AED before emergency responders arrive, according to 2018 research published in AHA’s flagship journal, Circulation.

Unfortunately, less than half (45.7 percent) of cardiac arrest victims get the immediate help they need before emergency responders arrive, in part because medical services take, on average, between four and 10 minutes to reach someone in cardiac arrest.

An international team of researchers looked at 49,555 out-of-hospital cardiac arrests that occurred in major cities in the U.S. and Canada. They analyzed a key subgroup of these arrests: those that occurred in public were witnessed by bystanders, and the patients were shockable. The researchers found that nearly 66 percent of these victims survived to hospital discharge after a shock delivered by a bystander. Their findings emphasized that bystanders—or for our purposes, coworkers—make a critical difference in assisting cardiac arrest victims before emergency responders can get to the scene.

Be the Difference. It’s Simple.

If you want to be a part of a larger culture of safety in the workplace and are interested in getting CPR and AED training at work, it’s not difficult to do. Helpful resources from quality organizations such as AHA provide beneficial training.

For example, AHA’s Heartsaver First Aid CPR AED Training course teaches participants to provide first aid, perform CPR and use an AED in a safe, timely and effective manner. The course is designed for those with little or no medical training who want to be prepared for an emergency in any setting.

The course covers the basics such as first aid as well as medical, injury and environmental emergencies. But it also delves into preventing illness and injury, opioid-associated life-threatening emergencies, Child CPR AED and Infant CPR in addition to Adult CPR and AED use.

You’ll just need to decide what type of training works best for your team. You could go with a blended learning approach, such as AHA’s Blended Learning Heartsaver First Aid CPR AED Online class, which combines online instruction with a hands-on skills session.

Or you could opt for a Classroom Heartsaver First Aid CPR AED class, which is an instructor-led, hands-on class format in either a training center or your place of business. Both video-based, instructor-led courses teach students critical skills needed to respond to and manage an emergency until medical services arrive. The practice-while-watching technique allows instructors to observe the students, provide constructive feedback and guide the students’ learning of skills.

AHA also offers a CPR First Aid Anywhere Training Kit, a video-based kit that can be easily facilitated by anyone to train hundreds of individuals.

Know that in response to the COVID-19 outbreak, AHA has issued optional instructional changes to its training network for its Heartsaver courses.

In the Age of COVID-19: Hands-Only CPR

Hands-Only CPR has been shown to be as effective as conventional CPR for cardiac arrest at home, at work or in public, according to the AHA.

But in the age of COVID-19, rescuers are unlikely to have access to adequate personal protective equipment. Therefore, rescuers are at increased risk of exposure to COVID-19 during CPR, compared to healthcare providers with adequate personal protective equipment.

The AHA has issued interim guidance on how lay rescuers should perform Hands-Only CPR, if they are willing and able, after recognizing an out-of-hospital cardiac arrest in an adult, especially if they are household members who have been exposed to the victim at home. AHA recommends a face mask or cloth covering the mouth and nose of the rescuer and/or victim may reduce the risk of transmission to a non-household bystander, such as a colleague at work.

Hands-Only CPR has two easy steps:

  1. Call 911 if you see a teen or adult suddenly collapse.
  2. Push hard and fast in the center of the chest to the beat of a familiar song that has 100 to 120 beats per minute.

Song examples include “Stayin’ Alive” by the Bee Gees, “Crazy in Love” by Beyoncé featuring Jay-Z, “Hips Don’t Lie” by Shakira or “Walk the Line” by Johnny Cash. People feel more confident performing Hands-Only CPR and are more likely to remember the correct rate when trained to the beat of a familiar song. When performing CPR, the beat of the song examples above corresponds to pushing on the chest at a rate of 100 to 120 compressions per minute.

Note that AHA still recommends CPR with compressions and breaths for infants and children and victims of drowning, drug overdose or people who collapse due to breathing problems.

To get a better sense of Hands-Only CPR, which is a natural introduction to CPR, you can watch a 90-section instructional video at heart.org/handsonlycpr. Then find a CPR class near you at heart.org/findacourse.

One last thing to keep in mind: In one year alone, 475,000 people die from cardiac arrest in the United States. While that’s a big number, it also presents a big opportunity. Consider being an organization that commits to proactively fostering a safe environment and empowers its people to take on a small social responsibility that can have a big impact at work, home and in the community as a whole.

Please note: The article was originally published in the June issue of Occupational Health & Safety magazine.

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Teen saves his mom’s life using Hands-Only CPR he learned in school

Pictured above: Kristen Walenga

By Gina Mayfield

It was late August 2019, and Saturday morning in the Walenga household was off to its typical All-American start. Kristen Walenga sent her husband off to work and geared up for her team mom duties as she made breakfast for her four children. Her daughter Rose, 14, got ready upstairs for cheerleading pictures and her youngest sons, Sam, 11, and Nate, 9, ran around outside to burn some energy before their youth football game.

The family’s eldest child, Eddie, 15, was in the basement playing video games when he heard a loud crash coming from the kitchen above him, followed by screams for help from his younger brothers who had just come inside. Then the family pet, a certified therapy dog, started howling. That’s when Eddie realized this wasn’t a typical Saturday at all.

He raced up the basement stairs to find his mom in a heap on the floor, and his two little brothers standing there in disbelief. At first, they thought their mother was just playing around.

Eddie, who had taken a Hands-Only CPR class a few years earlier in middle school, quickly realized his mom wasn’t breathing and had no pulse.

His training immediately kicked in and he began chest compressions while little Nate ran to get help from a neighbor. The neighbor’s son, who happened to be visiting, was a former Army medic and ran straight for the Walenga’s kitchen where he found Eddie performing CPR like a champ.

In the midst of the chaos, Sam had the presence of mind to call 911. Paramedics arrived, continued CPR and administered four AED shocks. They got a pulse and transported Kristen to the hospital where, a couple of days later, they removed her from a ventilator. She woke up from a medically-induced coma with an internal defibrillator firmly implanted in her heart at the age of 45.

“So I had a sudden cardiac arrest,” Kristen says. “They were not able to find any reason for it. It’s ‘idiopathic,’ or unexplained. Their best guess is that it was stress induced. I was a full-time teacher, the school year had just started. We’re a very busy family, and I had been working a ton that week.”

Later, one of the paramedics told Kristen that she was very fortunate. “He said that I had so many good things fall into place. Of course, one being a ‘witnessed’ cardiac arrest. Two, having someone at home who could start CPR within a minute or two.”

After some time went by, Kristen sat down with Eddie and said, “How did you know this was the right thing to do? How did you react so quickly and know to start CPR?” Eddie said that even after a couple of years, a few things stuck in his head from that middle school health class, including that he couldn’t do more harm than what was already happening to his mother. Secondly, he recognized that Kristen wasn’t breathing normally, so he knew that meant to start CPR.

Since her cardiac arrest, Kristen has taken what she describes as a serious interest in CPR by taking classes, going through an instructor course and getting certified. As is the case with so many survivors, Kristen immediately felt that it was no accident she was left on this earth.

Being a teacher herself, she questioned why educators weren’t being trained in CPR. “It just seems like a no-brainer. CPR should be a basic skill that everybody has in their pocket.” But it isn’t … yet. “We have several in-service classes that we have to do at the beginning of every school year. We have to know how to administer an EpiPen, manage diabetes and ADHD – all of these really important things. But I can’t think of anything more important than just being able to administer Hands-Only CPR.”

So Kristen discovered her calling: Creating awareness around the American Heart Association’s CPR in Schools program. Schools often don’t know how time- and cost-effective the program can be, and it’s the mission of her foundation, Kristen’s Heart Beats, to change that.

In the end, Kristen went back to those middle school health teachers who made the Hands- Only CPR class happen after writing a grant to the American Heart Association for the CPR in Schools training. They now teach the class at the sixth, seventh and eighth grade levels, but they shared that they initially had some reservations about applying for the grant and teaching the course: How receptive would middle schoolers be? Were they too young? Would they remember it? Is this worthwhile, is it going to work?

But Kristen was living proof they made the right decision. She simply replied, “If you hadn’t written that grant, I wouldn’t be here today.”

This week is National CPR and AED Awareness Week, spotlighting how lives can be saved if more Americans know CPR and how to use an AED. Did you know about 70 percent of out-of-hospital cardiac arrests happen in homes? Learn more about how you could save the life of a loved one by learning CPR today.

 

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Paramedic helps save newborn baby’s life

Pictured above: Kevin Thomas holding Sophia Ruth Smith.

Paramedic Kevin Thomas was close to ending his overnight shift in the early morning of February 2016  when he received one last emergency call for the day: a pediatric cardiac respiratory arrest in Pearl River, a New Orleans suburb.

The emergency involved a newborn baby named Sophia Ruth Smith, who was only six hours old and suffered a cardiac arrest after a home birth delivery.

As the ambulance sped to the scene 13 miles away, Kevin’s thoughts raced in his mind as he reviewed the steps he’d need to take to treat Sophia. It was his first pediatric cardiac arrest call.

“I don’t remember the drive to the house,” said Kevin, who works for Acadian Ambulance. “All I remember is being nauseated. Just that feeling of you’re going to have a child’s life in your hands. You just feel sick to your stomach.”

When the ambulance arrived at the home, the fire department was already on the scene. Sarah, Sophia’s mother, said her husband had been doing CPR on his daughter whose skin had turned blue. Kevin immediately provided aid to Sophia.

“He was on it from the moment he came into the house and took over the chest compressions and took over the CPR,” Sarah said about Kevin’s assistance. “He didn’t skip a beat.”

Sophia had a pulse, but she was having problems breathing. Kevin and his EMT immediately put a bag-valve mask on Sophia to deliver oxygen to her lungs to help her breathe and started an IV.

A helicopter ambulance had already been called to transport Sophia to the hospital, but Kevin realized that there was no time to wait for the helicopter. Sophia needed to get to the hospital immediately.

Sarah remembered how Kevin advocated for Sophia to be taken to a nearby hospital by an ambulance ride instead of a helicopter.

“He knew there was not time to get her to the helicopter and transfer her to the hospital,” she said.  “I remember he was on the phone with different hospitals because they didn’t want to take her. He fought and fought to get her to one close by.”

Sophia was rushed to a hospital via ambulance ride. Her prognosis was bleak. Sarah said Sophia suffered major organ failure and brain damage. The doctors told Sarah and her husband to let Sophia go, as she would be in a vegetative state and have no quality of life.

Fortunately, Sophia defied the odds and survived. She is now four years old.

“I look at her today and thank goodness that we followed our faith and that we didn’t make that choice,” Sarah said. “That we didn’t make the decision. That we left it up to God and his will and his way.”

Sarah describes her daughter as an outgoing, loving child who has a smile that lights up a room. Sarah said Sophia is nonverbal, but she communicates so well just who she is.

Sophia Ruth Smith

“She’ll let you know what she wants,” Sarah said.  “She is extremely independent. We have nine kids. We treat her like the other kids. I think that has helped with her development and her getting to the point she is today.”

Sarah said Kevin’s experience the day that he responded to the emergency call and provided treatment to Sophia made a difference.

“His experience was what we needed for her to be here today,” she said.  “When we left the hospital, her doctor over at Ochsner Baptist, the head doctor of the NICU, said there is no scientific reason why your daughter should be alive today. She was that bad. She was that sick. It was their (emergency responders) quick response and everything he did.”

Sarah will not forget how Kevin called the hospital after the incident to talk to the nurse to make sure that Sophia survived.

“God put the right people right where they needed to be,” she said. “Kevin will always have a huge place in our hearts forever.”

Kevin keeps in touch with Sarah and sees Sophia’s progress through a Facebook group that her mother started.

“l look at her Facebook page all the time because her mom posts a lot of things on the page because of her progression,” he said.  “She had a low chance of survival. And here she is four years old.”

Kevin began his career as an EMT with Acadian in 2004. He later earned his paramedic certification and now serves as a Critical Care Paramedic. His EMT training was based on American Heart Association guidelines. He was recognized as a finalist for Acadian Ambulance Paramedic of the Year for the Northshore region of the New Orleans area in 2018.

Kevin said he feels like he’s a savior for his community of Slidell, as he works to protect safety and health. He said EMS personnel provide pre-hospital care and can be the difference between life and death.

“They are special people who always put themselves in danger to help the ones in need,” Kevin said.

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School nurse and staff perform CPR and use AED to save co-worker’s life

School nurse Haley Pepper was about to snack on a donut in her office the morning of Sept. 20, 2019 when she heard a plea for help at Gateway Science Academy South, the elementary school where she worked in St. Louis.

“I’m hearing somebody scream, ‘Nurse! Nurse! Nurse!” she recalled.

When she stepped out in the hallway, she saw the school’s vice principal of operations, Mehmet Okay,  who yelled to follow him. She tossed the donut through the doorway toward her desk,  ran after Mehmet and followed him downstairs to his  office.

The school’s custodian was lying motionless on the sofa in Mehmet’s office. He was not breathing. The custodian had been eating an apple while chatting with Mehmet when his head suddenly drooped. Haley would later learn that he had suffered a heart attack.

Haley shook the custodian and checked his pulse. Erkan Bayer, who is the school’s technology teacher, had also just walked into the office. Haley immediately started giving out orders to get assistance.

Erkan ran to get the AED equipment while Mehmet called 911. Haley, who has a bad back, also quickly realized she would need a stronger person to lift the custodian from the sofa and lay him flat on his back on the floor.

“I remembered the gym was nearby,” she said. “ I ran to the gym, scanned the room and got the P.E. teacher. I said ‘I need help. Follow me.’

P.E. teacher, Kenyon Klousia, and two other staff members had moved the custodian onto the floor just as the AED arrived. CPR was soon started while Erkan was on the phone with dispatchers who were also giving instructions on the emergency response.

As they performed CPR, Haley said she had no idea if the custodian had choked on his apple or something else had stopped his heart and breathing.

“We had to check carefully if our breaths were going in, and a few times there was apple pieces in his mouth that had to be cleared away,” she said.  “So, we were constantly reassessing to make sure we were doing the right thing.”

Only three-and-half-minutes had passed by the time they started to use the AED and administered the first of two shocks. When paramedics arrived, the custodian was breathing and his pulse had returned.

“It was probably 15 minutes all around from the time we called 911 and by the time he was carried out to the hospital,” Haley recalled.

A week later, the custodian called the school to say hello as he recovered. Haley said she isn’t a runner, but she bolted to greet the custodian when he returned to the school weeks later to visit.

“I sprinted to go give him a hug when he came back to visit that day,” she said. “He started crying. I apologized for his sore ribs.”

As Haley reflects on the turn of events on Sept. 20, she said it was easy to make those decisions such as to call 911 and to get the custodian flat on his back. She said the hardest decision was realizing that she would need to do CPR on her friend.

“This isn’t something where I’m just putting a band-aid on someone,” she said. “This is serious…This just happened to my friend. Coming to grips with the fact that this is the  problem was a hard decision.”

She is grateful that Kenyon was nearby to assist. They both had participated in CPR and AED training together that was developed by the American Heart Association (AHA) and provided by CPR Plus, an AHA Community Training Center.

“I couldn’t have grabbed a better person than the P.E. teacher,” she said.  “I just thought I needed somebody strong to lift him off the couch.  He was amazing. We both remembered our steps from training. We both remembered what each other would be doing.”

Haley has performed CPR before. But she never expected that she’d need to perform the life-saving skill that September morning as she took a break to eat a snack when there were no children in the clinic.

“It was the last thing on my mind that one of my staff members was going to have an emergency at work,” she said.

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Global Impact: Understanding the AHA Education Statement in Japan

Dr. Takahiro Matsumoto

Article Contribution: Dr. Takahiro Matsumoto is head of a home-visit clinic in Ena City in Japan. He is an active volunteer and is the representative director of the non-profit organization JPSOCLS (Japan Patient Safety Foundation for Organizational Culture and Learning System).

 

Global Impact: Understanding the AHA Education Statement in Japan

In 2018, the American Heart Association (AHA) published a statement on cardiopulmonary resuscitation education in Circulation titled Resuscitation Education Science: Educational Strategies to Improve Outcomes From Cardiac Arrest. The statement was developed to promote the construction of learning content based on science and the application of instructional design, which is an area of educational engineering to promote education, training and implementation.

The statement says “Although millions of lay providers and healthcare providers are trained in resuscitation every year, major gaps exist in the delivery of optimal clinical care (ie, poor-quality CPR or no CPR in the out-of-hospital setting) for individuals with cardiac arrest” and that “enhancing instructional design in these contexts can improve educational outcomes (ie, provider knowledge, skills, and attitudes), which will ultimately translate to improved patient outcomes and survival after cardiac arrest.” [1] The application of instructional design was recommended.

In Japan, the Japanese Society for Instruction Systems in Healthcare (JSISH), an academic organization that promotes patient safety by applying instructional design to healthcare, has established an international training center (JSISH-ITC) for AHA Emergency Cardiovascular Care (AHA ECC) program. Instructional Design (ID) theory has been implemented in various educational activities within their programs. This statement recommends the application of ID to improve cardiopulmonary resuscitation education, but for many healthcare professionals, it may not be so simple to understand and apply to practice. We translated the AHA Education Statement to Japanese and published it. In addition, we published the article  “To apply the AHA proposals for resuscitation science education” in the Japan Journal of Health Professional Development (JJHPD), which is the JSISH’s academic journal for the exposition of the statement and proposal of the application in practice.[2]

Furthermore, to spread awareness and knowledge about the above, we held a symposium on June 15, 2019, about “Understanding the AHA statement for Cardiopulmonary Resuscitation Education.” During the symposium, instructional design experts, JSISH representative directors, and practitioners who apply ID to healthcare education presented exposition, proposals and real case studies of ID application in healthcare. These were recorded and will be distributed on DVD.[3]

The efforts continue after the symposium and there are new practice examples. One of them is a cardiopulmonary resuscitation course focused on the learning content for appropriate competence in clinical environment. Another example is a seminar for faculty development that CPR instructors to play active role as ‘change agent’ in their has to improve its performance.

If understood deeply and widely in Japan, this AHA statement has high possibility to support improvement and implementation of CPR but also to improve patient safety in Japan.

 

[1]https://cpr.heart.org/en/resuscitation-science/education-statement

[2] http://idportal.gsis.kumamoto-u.ac.jp/wp-content/uploads/sites/3/2019/04/JSISH_matsumotosuzuki.pdf

[3] https://www.zenkanan.info/dvd

Japan Patient Safety Foundation for Organizational Culture and Learning System (JPSOCLS)、https://www.zenkanan.com/

 

Matsumoto Takahiro, M.D., Ph.D

Okamoto Hanae, RN, MSN.

Shingo Kuroyanagi, CE.

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What’s Your Emergency Game Plan?

 

Lacrosse player and referee

What’s Your Emergency Game Plan?

by Gina Mayfield

On a beautiful autumn day this past November, families from across Washington State drove out among the apple orchards of Yakima Valley for the Northwest Fall LAX Fest. Against that quiet pastoral setting, no one would have expected the emergency that would end the tournament.

Referee Jeff Bambrick remembers the moment he saw high schooler Samuel collapse during the championship game. The clock had reached the 2- to 3-minute mark, when an offensive player fired a shot at the goal that struck Samuel instead. Initially, it appeared that he had just been hit in the lower abdomen as he crumpled to the ground. The coach and trainer came out on the field as Jeff spoke with the other officials to determine whether or not to stop the clock.

After a minute or so, Jeff went over to see how Samuel was doing. “As I walked up, I heard agonal gasping. It’s a very distinctive type of gasping,” Jeff says. “In my career I’ve heard it quite a few times, and I immediately recognized this guy is very near dead.” He knew to start chest compressions immediately as Samuel’s gear and helmet were removed while about 150 parents looked on from the sidelines.

Jeff’s 20-year career has been with the Tacoma Fire Department, where Jeff’s a lieutenant and serves as the training paramedic. He teaches CPR, advanced cardiac life support and pediatric life support to the 400-person department and general public as a Basic Life Support Instructor for the American Heart Association (AHA). He’s also been on a lacrosse field in some capacity – player, coach, ref – since his days as a high school player back in the ‘80s.

After a few minutes of hands-only CPR, Samuel started breathing again and Jeff could find a pulse. Just then, paramedics arrived and Jeff told them, “I’m pretty sure this is commotio cordis,” an often lethal disruption of the heart rhythm after a blow to the area directly over the heart at just the right time in the cycle of the heartbeat.

Jeff knows the condition well. “As long as they get CPR immediately and the brain gets oxygen again, they usually have a full recovery, and that’s what happened in this case,” he says. and the hospital cardiologist monitored him for 48 hours and sent him home. “He’s absolutely fine,” Jeff says. He knows this first hand. He and Samuel recently had the opportunity to reunite at another tournament in Seattle.

Commotio cordis started gaining attention in lacrosse circles back in the early 2000s after a few high-profile deaths raised awareness around the condition. It’s a higher risk in lacrosse so U.S. Lacrosse has had an AED grant program for more than 10 years.

Still, Bruce Griffin, PhD, and the director of the Center for Sport Science for U.S. Lacrosse saw the need for something more, beyond just the device itself – an accessible training program for youth coaches.

Often in youth sports there are no athletic trainers, EMS or other duty-to-respond personnel on-site, so if a cardiac arrest occurs during practice or during a game, it is important that coaches, parents and athletes are prepared to act. When the AHA released its CPR in Schools™ Training Kit, Bruce saw its potential and felt that with a few modifications it could be adapted to serve youth sports needs, so he reached out to the AHA.

Fast forward to LaxCon 2020, and the launch of AHA’s CPR & First Aid in Youth Sports™ Training Kit, designed for youth coaches to ensure they and their community know the lifesaving skills of CPR, how to use an AED and how to help during sports-related emergencies. Bruce calls it a game-changer for local youth sports organizations, typically run by volunteers with limited training. The kit allows the average person to facilitate training for 10 – 20 people, in less than an hour.

That’s time well spent considering sudden cardiac death (SCD) during sports is a tragic event that has a significant impact on friends, families, communities and sports organizations. Having an Emergency Action Plan (EAP) for coaches and their support team is key to survival in the event of cardiac arrest and CPR could double or triple a person’s chance of survival.

Not unlike others passionate about more “save stories” in sports, as a 15-year-old youth basketball coach, Bruce witnessed an incident that has stayed with him all these years – an official had a sudden cardiac arrest right in front of him. He didn’t know what to do, but the mother of one of his athletes performed CPR and the official lived. That made him never want another coach to face that situation without the knowledge of how to help.

Knowledge is indeed power in these situations – the power to save someone’s life. As both a paramedic and ref, Jeff has his own take on the importance of an EAP and asking all the right questions before a game: “How does the ambulance actually get to where we are? Do we have to open a gate? Do they have to drive onto the field? That’s all stuff you need to plan out beforehand in a pregame meeting,” he says. “It’s so important that the coaches and referees know where the emergency equipment is. The wrong time to find out is when something bad happens. You have to have a plan in place.”

 

Learn to save a life today at www.heart.org/CPRinYouthSports.

 

 

 

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Game Changer:  The Lifesaving Story of a Beloved Texas Football Coach

Football coach Chris Foley

Pictured Above: Chris Foley

by Gina Mayfield

When most people think of Texas high school football, the heat of those Friday Night Lights first comes to mind. But, in reality, one of the biggest opponents coaches and players face is the intense heat of the sun, with temperatures rising well above 100 into the school year.

August 16, 2019, was no different. The morning started off as usual at Plano East Senior High, with an early morning football practice beginning on the outdoor turf. As the temperature climbed, the coaching staff corralled its 150 players and starting moving toward the indoor facility to continue training.

“I always stay back to grab all the water, I’m the last one off the field,” says Chris Foley, the team’s athletic trainer. That morning, he noticed two coaches trailing behind the team. Suddenly one of them, Assistant Head Coach Tom Rapp, collapsed to the ground.

As the second coach came upon him, he noticed Coach Rapp was unconscious and started performing CPR as he called out for Chris, who has a master’s degree in athletic training. “We’re there for all medical reasons,” Chris says of the role of an athletic trainer. “If people get hurt, or someone goes down, that’s where I would step in. The coaches are all trained in CPR, but if something happens, they would go get me.” And this incident was no different.

Chris wasted no time. “I sprinted over there and took over CPR, sent another coach to go get the AED and we had someone calling 911. We got the AED over there, and I stuck the AED on Coach Rapp and we alternated shocking him and chest compressions for about 12 – 15 minutes. The AED shocked him four times. The last time was right as the paramedics were getting there.”

As they pulled up in the ambulance, Chris started another round of compressions and the paramedics made their way to the scene. “Coach Rapp regained a pulse, but didn’t regain consciousness until he was in the back of the ambulance.” The head coach rode to the hospital him, where they were later met by most of the coaching staff and a district administrator. By that point Coach Rapp was up and talking, but didn’t remember anything that had happened.

Turns out he had gone into cardiac arrest. “He had an electrolyte imbalance in his heart. They said it was a combination of low potassium level and just it being so hot.” Chris learned that Coach Rapp had a history of heart issues and was on medication. “It was a perfect storm for him.”

Nine days later Coach Rapp emerged from the hospital with a cardioverter defibrillator implanted in his chest. Eventually he made his way back to the gridiron, at first only watching from the sidelines from the comfort of a golf cart the school borrowed for him. “It was tough for him,” Chris says of the early recovery process.

These days, those limitations have been lifted. “Now that he’s back, he’s back full go, no restrictions. The only thing he needs now is a special Gatorade drink every day at practice because of his electrolyte imbalance,” Chris says with a smile.

Coach Rapp has thanked Chris and the coach, Brad Bailey, who initially performed CPR. But they always have the same response. “We keep telling him that he would have done the same for us. There’s just no thanks needed. That’s what we’re there for.” They’re grateful to have their friend on the field with them.

“To know Tom Rapp is to love Tom Rapp. It’s great having him back because he’s that coach that everyone loves, so it was strange him not being there,” Chris says. “You couldn’t have asked for a better guy to help.”

Click here to learn more about how you can become trained in CPR, first aid, and how to use an AED.

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World Restart a Heart Day 2019

a group learning CPR

 

On October 16, we will be celebrating World Restart a Heart Day, a global initiative to increase awareness about the importance of bystander CPR.

Each year, more than 350,000 out-of-hospital cardiac arrests occur in the United States. Yet, only about 46 percent of people who suffer from cardiac arrest receive CPR from a bystander.

This is a statistic we need to improve so that all people who experience an out-of-hospital cardiac arrest get bystander help before emergency responders arrive. CPR, especially if performed immediately, could double or triple a cardiac arrest victim’s chance of survival.

We hope you will recognize World Restart a Heart Day with us by sharing the two easy steps to Hands-Only CPR, a technique that the American Heart Association recommends to help increase the likelihood of people performing CPR in an emergency. 1) Call 911. 2) Push hard and fast in the center of the chest to the beat of a familiar song that has 100 to 120 beats per minute.

To promote World Restart a Heart Day, we encourage you to share your training photos or videos in front of an iconic location in your market using the hashtag #worldrestartaheart.

For more information about World Restart a Heart Day, visit: https://www.ilcor.org/world-restart-a-heart-2019

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Care Considerations for the Pediatric Post-Cardiac Arrest Patient

This blog entry is based on content from a podcast interview with Mary McBride, MD, FAAP, MEd, Associate Professor of Pediatrics at Northwestern University Feinberg School of Medicine and pediatric cardiac intensivist at Lurie Children’s Hospital in Chicago, and Alexis Topjian, MD, MSCE, Pediatric Critical Care Medicine Physician at Children’s Hospital of Philadelphia. Listen to the full podcast titled Care Considerations for the Pediatric Post-Cardiac Arrest Patient.

Dr. McBride: What is post cardiac arrest syndrome?

Dr. Topjian: I think we really focus oftentimes on our immediate resuscitation. We get a pulse back in our patients and we’re so happy to have a pulse back, but at that time we’re really entering a new phase of our resuscitation, and that’s the post cardiac arrest syndrome. The post cardiac arrest syndrome begins from the earliest moments after resuscitation, and it’s traditionally thought of as four key components.

The first is brain injury, which we know occurs during the time of hypoxia and ischemia. There’s a component of myocardial dysfunction, also due to hypoxia ischemia. Then there’s a systemic ischemic reprofusion response. Then finally the component of what preexisting pathophysiology, so whatever led to your cardiac arrest in the first place.

This is sort of a complex interplay of factors that we will talk about a little bit more that tend to ebb and flow over time from the earliest moments after resuscitation, and can really go on for days and can have long lasting effects on the patient that can impact outcome.

Dr. McBride: How might this differ from pediatrics to adults?

Dr. Topjian: I think kids are inherently different than adults in several ways. Obviously in size and development, but really the cause of arrest is different between adults and children. Children don’t have much coronary artery disease. They typically will have arrests that are more commonly associated with asphyxia, so from respiratory illness. And especially in the out-of-hospital population, we will see more prolonged downtimes for really young infants. Adults more commonly will have a ventricular fibrillation or ventricular tachycardia arrest, and so it will be shockable. Really, children are much less likely to have a shockable initial rhythm.

We also have a special circumstances in our children’s, so congenital heart disease is common, and so we will see that complex interplay of factors as well. I think as we look at children, we really see their causes of arrest are different, which impacts their resuscitation, and then impacts the time period after their resuscitation.

Views expressed in this podcast and on this blog do not necessarily reflect the official policy or position of the American Heart Association and American Stroke Association. For transcripts of this podcast and more information about resuscitation science, please visit CPR.heart.org or engage with us via social media using #ECCDigitalDigest.

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How AHA Creates the CPR Guidelines from the ILCOR CEE Process

This blog entry is based on content from a podcast interview with Robert Neumar, MD, PhD, Professor and Chair of the Department of Emergency Medicine at the University of Michigan and Chair of the American Heart Association Emergency Cardiovascular Care Committee and AHA delegate to the International Liaison Committee on Resuscitation (ILCOR); Mark Link, MD, Professor of Medicine and the Director of Cardiac Electrophysiology in the UT Southwestern Department of Internal Medicine’s Division of Cardiology, and Karl Kern, MD, co-director and the Gordon A. Ewy, MD Distinguished Endowed Chair of Cardiovascular Medicine at the University of Arizona Sarver Heart Center, and professor of medicine at the UA College of Medicine – Tucson. Listen to the full podcast titled How AHA Creates the CPR Guidelines from the ILCOR CEE Process.

Dr. Karl Kern: Can you give us just a kind of an overview of how does the American Heart Association do this task of gathering the science and turning it into meaningful guidelines?

Dr. Mark Link: First I think it’s important to realize what the guidelines are. They’re written instructions for how to take care of people in cardiac arrest. These guidelines have been written by the AHA for a couple, if not three, decades. The documents include CPR, ACLS, Pediatric ACLS, and it’s a complex process of how they’re put together, using the latest science and they’re continually updated, and we’ll be going over that in our talk here about how we actually create these written documents and how they’re disseminated into the community.

Dr. Karl Kern: How do you find the science?

Dr. Bob Neumar: Sure. The science evaluation process really begins with ILCOR, which is the International Liaison Committee On Resuscitation, and this is a consortium of resuscitation councils similar to the American Heart Association across the world, that brings together the world’s experts in the field to evaluate the current science and then generate a consensus on science and then draft treatment recommendations using grave methodology that then is used by member councils to develop their guidelines.

Dr. Karl Kern: Who else is in there besides the Europeans and the U.S.?

Dr. Bob Neumar: The member councils include the European Resuscitation Council, the Inter-American Heart Foundation, which is in South America, ANZCOR, which is the Australia and New Zealand Resuscitation Council, Resuscitation Council of Asia, the Southern African Resuscitation Council. So a good representation across the world.

Dr. Karl Kern: So Mark, tell me how the American Heart takes this science review materials from ILCOR and actually then produces the American Heart Guidelines for CPR and resuscitation.

Dr. Mark Link: You wanna take back a little bit into history. It used to be that the AHA would do their own science review and then do the guidelines from their own science review.

It was realized that that wasn’t a great system for a number reasons. One is that, resuscitation science is the same all around the world. There are more and more councils being interested in this. So it was thought to develop one body that does the science and then the individuals councils, such as AHA, can take that science and turn that into guidelines that are really more specific for the council. And the AHA’s council, they AHA constituents are basically U.S. and Canada. There’s a writing group that is constituted by the AHA. They take the document from ILCOR, that has looked at the science about resuscitation and specific questions about resuscitation and they really write specific recommendations that are in understandable language so that EMSs, physicians, nurses, systems can actually use the AHA recommendations to guide how they take care of patients.

Dr. Karl Kern: And it sounds like that it’s possible, Bob, that different councils could actually have slightly different guidelines depending on their circumstances and abilities to put into practice the science that’s been reviewed.

Dr. Bob Neumar: Yeah, that’s exactly right. Obviously, the ultimate goal of ILCOR is for everyone who has a cardiac arrest or requires resuscitation across the world should have access to the same level of care. But the resources aren’t always available in every setting, so one of the advantages of the way the ILCOR Guidelines are written, which recommend for or against, and that’s a strong or weak recommendation, is the councils can use that recommendation based on science and apply it to the environment that they are practicing in and really tailor it to the resources that are available.

Views expressed in this podcast and on this blog do not necessarily reflect the official policy or position of the American Heart Association and American Stroke Association. For transcripts of this podcast and more information about resuscitation science, please visit CPR.heart.org or engage with us via social media using #ECCDigitalDigest.