Ric and Ann Goheen
It was a typical Sunday morning for Ann and Ric Goheen on April 5, 2020 at their home in Novato, a city located in the San Francisco Bay Area. Ann read a book in bed while her husband, Ric, who has sleep apnea, slept next to her as he wore his CPAP mask.
Ann looked up from her book when she heard air escaping from the edge of Ric’s mask. She poked his side and told him to check his mask. But Ric didn’t respond. She ripped off the mask and saw his lips were blue. Ann, who is a nurse and used to work on a cardiac floor, did a brief pulse check on him and realized he was in cardiac arrest.
“We were just really lucky that I was awake and noticed and of course that I was trained to do CPR,” Ann recalled.
She immediately started CPR. Then, in a whirlwind, Ann stopped to call 911, chased their dogs MicMac and Rio out of the bedroom and unlocked the front door so that paramedics could enter when they arrived.
Ann used all of her strength to move Ric from the bed and lay him on the floor so she could continue to perform CPR.
The paramedics arrived quickly as they happened to be a block away when they were alerted about the incident.
A fireman stayed with Ann while the paramedics shocked Ric six times before there was a return to spontaneous circulation to his heart. Paramedics rushed him to the hospital where he was intubated.
On the third day of his ICU stay, Ric was extubated. The nurse brought a phone into the room and put Ric on speakerphone so Ann and their three sons could talk to him.
“I love you all,” Ric told his family as they cried on the other end.
Ric spent nine days in the hospital and then was transferred to another hospital where he had an automated implanted cardio defibrillator implanted in his chest. He didn’t suffer any neurological issues.
Two months later, the Novato Fire department held a ceremony to recognize the first responders who treated Ric and to honor him. Ric wore a blue shirt with a green EKG rhythm over the words, “Annnd…I’m back.”
Ric gave a few remarks at the ceremony where he shared how much his family meant to him and told the paramedics how much he appreciated their lifesaving actions.
“I’ve always told my whole family how much I love them from the very start,” he said as he looked at the first responders. “And what you guys did is that you gave me another chance to tell them again how much I love them and how important to me they are. And you guys are my family also. I love every one of you. I appreciate you all very much.”
A year later, Ric, who previously restored antiques for dealers, continues to do well. He works on his garden every day.
As Ann reflects on her husband’s cardiac arrest, she said she was absolutely not ready for her husband to pass away. Ann, who is a former CPR instructor who received CPR training from AHA, said she wanted to try to do everything she could to ensure that he survived that day. She hopes others will feel compelled to also take action and start CPR if somebody they know or love suffers a cardiac emergency.
“The important thing that I want to pass along is to just try, “ she said. “Even if it’s scary or even if you don’t think you know how to do it, just try because you can make a difference.”
If you are called on to give CPR in an emergency, you will most likely be trying to save the life of someone you love: a child, a spouse, a parent or a friend. Hands-Only CPR has been shown to be as effective as conventional CPR for cardiac arrest at home, at work or in public. Learn the two easy steps of Hands-Only CPR by watching a short training video.
By Gina Mayfield
It was one of those mornings. Every parent knows the drill: You’re running behind, then a child decides he’s not on board with the usual morning routine, one thing leads to another and before you know it, you’re three hours late for work.
That was Patty Hill’s experience one hot August morning. Shortly after she finally arrived for her shift at Hartsfield-Jackson Atlanta International Airport, she stepped aside to take a phone call from her mother. Minutes into the call, Patty heard a cry for help. Then another. At that point, she quickly said to her mom, “I’m gonna call you right back,” and said to herself, Let me see what’s going on.
What was going on was the manager of the food court, Ms. V, as she’s affectionately known around ATL, was laid flat out on the ground. She had hit her head as she fell on the concourse and was completely unresponsive. At first it appeared as though a young woman was administering aid, but upon closer inspection, Patty realized that wasn’t quite the case.
“I looked at her as she was checking for a pulse … with her thumb,” Patty says. At that point, she knew she had to intervene. “I was like, uh-uh. I tapped her on the shoulder and said, ‘Step back, baby.’ Once I got down there and used my two fingers to find there was no pulse, I started chest compressions immediately.”
Because of airport security requirements, Patty had routinely carried a see-through bag to work, one that clearly displayed her bright orange resuscitation mask pack. A coworker had once jokingly asked her, “Why do you carry that?” Patty responded with her usual quick wit. “You never know, I might have to give you all mouth to mouth one day, and I ain’t putting my mouth on y’all,” she laughed.
As it turned out, the very same coworker who had questioned the contents of Patty’s purse happened to be standing feet away from Patty as she administered chest compressions. “Go get my purse,” she instructed between compressions. “Go get that orange thing out of my purse.”
Being at a busy airport full of passengers, it wasn’t long before a doctor and nurse came running over. The doctor used that orange mask to deliver breaths, while Patty and the nurse took turns delivering chest compressions.
Then the doctor turned to Patty and asked the million-dollar question: Do you know where to find the AED machine? As it turned out, Patty had been standing right next to it during that phone call with her mother.
Eventually Patty’s manager came looking for her. “I didn’t know you were gone saving a life!” she said to Patty. In fact, that’s exactly what she was doing — the paramedics showed up about 20 minutes later.
Soon after, Patty had a chance to catch up with Ms. V at the hospital where she was being treated for cardiac arrest. “I met her kids, I met her family, I prayed over her. She is good,” Patty says.
Then she reflected on her own experience. She had received her CPR certification while training to be a medical assistant, but worked nights at the airport while completing an unpaid internship. “When I graduated as a medical assistant, I was always asking myself what I was doing at the airport. It was for a reason. God had me there for that particular day, August 1, 2018. I will never forget that,” she says.
Today, Patty is an instructor who teaches American Heart Association curriculum to her community. “I never thought that I would be saving somebody at the airport. I never thought I would take those skills that I learned to help save someone,“ she says. “It’s good to know CPR. Even kids. I encourage kids to learn as well. I think everybody needs to learn.”
In the end, on that particular hot August morning, it turns out Patty wasn’t late at all. She was exactly where she was supposed to be, exactly when she was supposed to be there. “Now that I look at it, it was right place, right time,” Patty says. “Everything was right on time.”
Join a Nation of Heartsavers today at cpr.heart.org/heartsaver. #CPRwithHeart
By Gina Mayfield
On a crisp day in early autumn, the Hampton Inn in Greenville, North Carolina, was quiet during the afternoon lull between check-in and check-out periods. Sandi Parker manned the front desk while using the downtime to untangle a problem with tech support over the phone. That’s when it happened.
“I had a guest come running down the hall just yelling. I didn’t know what was going on. She got to the desk and said, ‘There’s a man unresponsive on the fifth floor in the hallway,’” Sandi remembers. She immediately ended her call with tech support and placed a different kind of call for help, this time to 911. Then she ran to the backroom to grab the emergency kit. “It was scary because I didn’t know what situation I was going to walk into,” she says.
Sandi bolted up the five flights of stairs to find a couple of hotel guests frantically trying to render aid. “It just looked bad. The man was completely unresponsive. His body was gray. I thought he was dead. I really did,” Sandi remembers. She immediately began CPR while praying for the man’s life between counts.
Sandi had remained on the phone with the 911 dispatcher who counted out chest compressions, making sure Sandi kept pace. “After 20 minutes, you start getting tired. You just don’t realize it. You start slowly slowing down. But the dispatcher was like, ‘Nope, nope, you’ve got to speed back up. One, two, three … .’ She was great helping me through that,” Sandi says. “Once you get started, you’re locked in. The adrenaline kicks in and you just get in the zone.”
In time, fire and rescue, the local fire department and finally the EMTs converged on the scene. The man eventually regained consciousness before being transported to the hospital.
Sandi returned to the front desk to find a large contingent of the hotel’s management company ready to support her. In a true display of Southern hospitality, they reached out to the medical center to ensure the man had survived and had been cared for by family. That was the last they heard about him. “I have wondered how he is,” Sandi says.
What she doesn’t have to wonder about is the role she played in those crucial first few minutes before professional help arrived. The hotel provides certain personnel, including those working the front desk like Sandi, with CPR training. On a regular basis, they clear out a meeting space, bring in an instructor and get certified. “To be honest, I’ve had CPR training for years,” Sandi says, “but I never thought I’d have to use it.”
Join a Nation of Heartsavers today at cpr.heart.org/heartsaver. #CPRwithHeart
The American Heart Association (AHA) recently published its 2020 AHA Guidelines for CPR and Emergency Cardiovascular Care (ECC) in the organization’s flagship journal, Circulation. Among the major changes are the addition of a sixth link focused on recovery in the AHA’s Chain of Survival, a widely-adopted series of critical actions that work to maximize the chance of someone surviving cardiac arrest.
The latest research shows that the recovery phase following cardiac arrest continues long after hospitalization. The physical, social, and emotional aspects of recovery among patients and their caregivers are emphasized after survivors leave the hospital.
The guidelines contain updated or new algorithms and graphics to reflect the latest resuscitation science, including:
- a new Recovery link in the Chain of Survival was created for in-hospital and out-of-hospital cardiac arrest in infants, children, adolescents, and adults;
- a new algorithm and updated recommendations on resuscitation during pregnancy focuses on the best outcomes for both the mother and baby. Team planning for cardiac arrest in pregnancy should be done in collaboration with the obstetric, neonatal, emergency, anesthesiology, intensive care, and cardiac arrest services;
- addressing the increase in respiratory and cardiac arrests due to opioid overdoses, two new opioid-associated emergency algorithms are included for lay rescuers and for trained responders; and
- new data on respiratory rates during CPR in children are now available, and the recommendations for pediatric CPR is one breath every 2 – 3 seconds (20 – 30 breaths per minute).
The AHA Chain of Survival now includes a sixth link focused on recovery.
Guidance calls for increasing bystander CPR
The 2020 guidelines offer suggestions for increasing lay rescuer CPR rates, noting that currently less than 40% of non-hospitalized adults who experience cardiac arrest receive layperson-initiated CPR before the arrival of emergency medical services. Among the new or updated suggestions are the following:
- raise awareness of the need for laypersons to initiate CPR for presumed cardiac arrest, underscoring that the risk of harm to the patient is low;
- emergency dispatch systems are encouraged to use cell phone technology to recruit laypersons to assist with CPR rescues, especially in under-resourced areas in an effort to increase the rate of bystander CPR and automated external defibrillator use; and
- bystander CPR training should target specific socioeconomic, racial, and ethnic populations who have historically exhibited lower rates of bystander CPR. CPR training should address gender-related barriers to improve bystander CPR rates for women.
Bringing science to life
For the first time ever, the latest resuscitation science is reflected in new high-quality CPR programs that released simultaneously in the form of a new digital resuscitation portfolio — a milestone achievement and breakthrough for the AHA.
The programs are rooted in a true adaptive learning design that delivers personalized instruction tailored to individual needs and knowledge and confidence levels.
The simultaneous release upholds an AHA Guiding Value – Bringing Science to Life.
The AHA also released Basic Life Support (BLS), Advanced Cardiovascular Life Support (ACLS), and Pediatric Advanced Life Support (PALS) course materials for instructor-led training.
Guidelines’ approach and history
The approach for the 2020 Guidelines reflects alignment with the International Liaison Committee on Resuscitation (ILCOR) and associated member councils and includes varying levels of evidence reviews specific to the scientific questions considered of greatest clinical significance and new evidence.
Since the first AHA Guidelines for CPR and ECC were published in 1966, the guidelines have been reviewed, updated, and published periodically by the AHA.
In 2015, the process of five-year updates was transitioned to an online format that uses a continuous evidence evaluation process rather than periodic reviews. This allowed for significant changes in science to be reviewed in an expedited manner and then incorporated directly into the guidelines if deemed appropriate.
The AHA has been a leader in resuscitation science and innovation for over 50 years, training millions of people each year in CPR, first aid and advanced cardiovascular care around the world through its programs and awareness campaigns.
Visit the ECC Digital Digest to view infographics that cover key guidelines changes and listen to podcasts from resuscitation experts who were involved in creating the guidelines.