Out in a far-flung corner of southwest Colorado sits Moffat Consolidated School District #2, home to the Moffat PreK-12 School Cowboys and Crestone Charter School (K-12). Both schools have a grand total of just over 200 students … combined. “It’s a small community, the town of Moffat has a little over 100 people in it,” says district school nurse Sarah Elchos, MSN, RN. “It’s not really a small town, it’s more frontier.”
With that designation comes challenges, especially in regard to the availability of emergency services. “One is Moffatt and Crestone do not have a nearby hospital. The closest one is 35 minutes away, and Moffat doesn’t have an ambulance service,” Sarah says. In the event of an emergency, the schools have to rely on neighboring towns for help, which can mean a 35-minute wait before lights and sirens reach their front door. “So there really is a need for our people to actually be able to save someone while we wait on the ambulance,” Sarah says. “And we didn’t have a CERP in place.”
A CERP, or Cardiac Emergency Response Plan, can increase sudden cardiac arrest survival rates by 50 percent or more by enabling a trained lay-responder team — such as teachers — to take action until Emergency Medical Services arrive.
“Through my school email, I got an invitation to a free, online Project Adam webinar from the American Heart Association (AHA) and Children’s Hospital Colorado,” Sarah says. Project Adam is a nonprofit that helps schools establish a CERP through its Heart Safe Schools program.
“They actually have a tool that helped me fast track my plan,” Sarah says. “It had a checklist and explained everything needed for the school CPR/AED progam. It’s a step-by-step guideline. It was exactly what I needed.”
Indeed, Project Adam provides the foundation for schools to plan and develop their own program, including CERP templates, a reference manual and even one-on-one consultation. Everything is customizable, even for schools on the frontier. Also, because of Sarah’s seminar attendance, the district received free mannequins and other educational supplies to teach hands-only CPR and AED training to students.
“I got the CERP written and approved through the superintendent, and she let the school board know,” Sarah says. Through a nurse grant from the Colorado Department of Public Health and Environment, Sarah got the additional hours she needed to work the plan, going from just 20 hours per week to 40.
First, she ordered the American Heart Association’s Heartsaver® CPR/First Aid/AED Training, designed for anyone with limited or no medical training who wants to learn how to give CPR and use an AED in a safe, timely and effective manner. “I wanted us to really be prepared if something happens,” she says. “We had AEDs, and I’m an old ICU nurse, so I wanted to make sure people knew how to use them,” Sarah says. “Initially, I was shocked by the number of ‘Oh, we have an AED?’ questions.”
During the 2020-2021 school year, she used the AHA Heartsaver course to train 19 teachers, as well as a group near and dear to her heart — interested graduating seniors, just in time for them to go off into the world. She also taught hands-only compressions to fourth and fifth graders at the Moffat school.
Toward the end of the school year, it was time for a drill, which proved helpful. Sarah placed a dummy in the front office, and so it began. “The call for help was put out over the walkie-talkies. That’s one thing we immediately identified that we need to do better, make sure the whole school is aware, not just the walkie-talkie users.”
She now awaits the results of her submission to Project Adam for Moffat to be designated as a Heart Safe School. She’s hopeful that the Title 1 school has enough AEDs to qualify, meaning one available in three minutes from anywhere on the facility. Come June, Sarah will be able to apply for a grant to get even more AEDs. “I have everything ready to apply,” she says, in true Sarah style.
“It’s all been well received,” she says. “This was my first time teaching children, and I felt more comfortable starting with the younger classes, then I’ll move on to the older groups. I really want to teach hands-only to middle school up to tenth grade, and I’m hoping I can expand the AHA Heartsaver to eleventh and twelfth grades every other year.”
So what’s been her biggest secret to success? “It’s just perseverance and staying on top of it,” Sarah says. “There’s no need to put a lot of pressure on yourself. Just let it flow.”
For Pamela Seamans, the last weekend in September always brings with it an adventure of sorts for her and her girlfriends, most in their 50s. “We’ve always taken an annual girls’ trip, and we always try to find something that’s a little, you know … edgy,” she says with smile.
September 2022 proved no different with a three-hour drive to the Catskills for an excursion that would involve a little more than just leaf peeping. By day three of the trip, they had already conquered so much, including pedaling their way on rail bikes through the woods of the Catskill Mountains. After breakfast, they made their way to the local ski lodge to hit the zip lines. Music played as they suited up in zipline gear and headed to the top of the mountain on a ski lift for a quick rundown of what to expect. “It was a little unnerving at first because we thought we were going to do some casual ziplining,” Pamela says. “This was a 610-foot cliff.”
Pamela volunteered to go first, soon followed by her friend Mary. “She did something kind of funny. She kind of did this little look, like she passed out. But she came right back around and was talking to us. We wondered what was going on at first, and watched her, but she said nothing about chest pain,” Pamela says. Knowing Mary’s fear of heights – “she’s petrified,” says Pamela – and understanding what a challenge the course was, they chalked it up to a little blip.
“I’m a nurse of over 30 years. I’ve been in critical care. I teach American Heart Association ACLS and BLS. I was watching Mary, and she was really good. So we did lots of challenging things, and we were finally approaching the launch spot of our last zipline,” Pamela says. That’s when they all heard Mary say, “I think I’m going to pass out,” before she fell to the ground.
Pamela ran to her and immediately could see Mary’s ear turning “as blue as blue could be” through her helmet. Pamela turned her over on her back, and initially thought Mary had an aortic aneurysm that had ruptured because her color turned so quickly. If that were the case, there would be little she could do. “I didn’t know,” Pamela says and decided to do what she could. “So I yelled out, ‘I’m starting CPR!’ thinking that I was going to get a bunch of people to go, ‘Oooh, I know that!’” Nobody budged.
She asked if there was an AED and instructed the crowd to call 911. Pamela started CPR and after several minutes made a plea to the crowd, “I am not going to be able to sustain this. I’m going to need somebody to help.” Two people stepped forward, one who had never taken a CPR class and one who did many years earlier. Pamela said to that second person, “That’s fine. I’m going to talk you through everything.” So she did.
“I told him, ‘As soon as I go to do my breaths, I need you to place your hands exactly where mine are,’” Pamela says. “I gave her two breaths and said, ‘Okay start. I’ll adjust you if I need to.’ I count my blessings. He was phenomenal. I couldn’t have asked for a better person.”
He continued compressions while Pamela used a pair of bandage scissors to remove Mary’s clothing, just in time for the arrival of the AED. “When we stood clear, she was in a shockable rhythm, so we were able to administer that first shock,” Pamela says. Then came more compressions and breaths, and Mary had a very faint heartbeat. “So we all started rallying and yelling for her – Mary, you can fight! – and you could see things changing,” Pamela says.
One of the local guides was holding Mary’s hand, and he said he could feel her hand getting warm, then she squeezed his hand and he could feel her heartbeat becoming stronger and faster. “The next thing you know, she was trying to sit up,” Pamela says. Just then, the EMTs arrived – 30 minutes after the call went out to 911. “Being a healthcare worker, I have never had anybody I’ve worked on for 30 minutes not only survive, but survive with no deficits,” Pamela says. But that’s what happened to Mary because two people who knew CPR intervened on her behalf.
Because this incident happened “on a mountain in the middle of nowhere,” as Pamela says, Mary had to be transported in the rescue basket of an ATV to a cleared parking lot where a medical helicopter landed to rush her to Albany Medical Center.
Pamela eventually reconnected with the man who helped her, and he shared a moment from their rescue that really stuck with him. Pamela had said to him, “Listen, you are her heart right now, and I’m her lungs. We are the only things that are physically keeping her alive.” The man said to Pamela, “I didn’t realize how important, and what a huge impact CPR truly, truly makes if you do it right.”
Late that night, the girls got a call – from Mary herself. “We all just started screaming,” Pamela recalls. Mary had a widow-maker heart attack, was in the Critical Care Unit, but could see visitors the next morning. With the image of Mary’s blank stare still fresh in her mind, Pamela walked into that hospital room. “As soon as I saw her, that’s when it really, finally sunk in. It was her eyes. She’s got these beautiful, beautiful blue eyes. That was one of the very first telltale signs that told me she was coming back while we were working on her. So when I walked in and I saw her eyes and that blue … . She just started crying when she saw me and vice versa.”
Plans are already in the works for next year’s girls trip – one not quite so “edgy.” In the meantime, they’ve all gotten together with their families to learn CPR, and Pamela is back teaching CPR at her hospital. “I now have a story, a truly awesome story. I tell my classes, ‘Listen, this is a gift this hospital is giving you. I worked on a very good friend of mine for 30 minutes, and it made a difference. I turned her around, and we still have her today. CPR is something you want to know.’”
On a busy weekday, as Kansas City Metro Patrol Officers Richard DuChaine and Charles Owen sat in their patrol car finalizing notes on a previous call, another one came in: Medical nature unknown. A 1-month-old was not breathing.
“Before the call was even completely dispatched to us, I already had the car in drive and we were on our way with our lights and sirens. We wanted to make sure the parents could hear us coming,” Officer Owen says. Luckily, they just so happened to be extraordinarily close to the address provided by dispatch. They arrived to find a very cute toddler holding the door open for them.
“It felt like they got here in 30 seconds, but it may have been a minute or two,” says Tajanea Allen, the mother of the baby in distress, Ka’Miyah. “The dispatcher had just said to me, ‘I’m going to direct y’all through CPR,’ but before he even had a chance to do that, Officers DuChaine and Owen were running up to our house.”
Turns out that morning baby Ka’Miyah had woken up in a very lethargic state. “She wouldn’t stay awake or keep her eyes open. Her dad knew something was wrong. His instincts just kicked in. Then she just took a deep breath. That was her last breath,” Tajanea says. They frantically tried calling the local hospital, but it quickly became clear that it would take too long to get through. That’s when they called 911 and the officers took off for their home.
“We ran in and when I saw the baby, I thought it might have been a prank call because she was so small, she looked like a doll,” Officer Owen says. Sure enough, the 1-month-old was a preemie whose original due date was still more than a week away. She weighed just over 4 pounds. Dad handed the baby off to Officer DuChaine. “She was lifeless, she was really gone,” Tajanea says.
Fortunately, the Kansas City Metro Police prepares its officers well with CPR training every year. “We have adult-size manikins and we have manikins for babies, so we’ve actually practiced this scenario numerous times,” Officer DuChaine says. “Once I had the baby in the palm of my hand, I didn’t feel a heartbeat at all. So that’s when I immediately started doing infant chest compressions.”
They wanted to make sure Ka’Miyah absolutely didn’t have anything in her airways. “That was when we could see life start coming back to her,” Officer DuChaine says, noting they got her on her side and checked her airway. “She finally started breathing again, which was a sigh of relief for us.”
Shortly thereafter, EMS arrived on the scene and asked the parents for a car seat to transfer Ka’Miyah to a major children’s hospital. About 2 hours after she arrived, she went into cardiac arrest and ended up in the ICU.
Throughout the day, the officers couldn’t stop thinking about baby Ka’Miyah. “This whole thing got to me because I had a preemie daughter myself, so I knew exactly what those parents were feeling at that point in time. I’ve been in their shoes,” Officer DuChaine says. Eventually they asked their supervisor if they could make a follow-up trip to the hospital and off they went.
That’s where they learned doctors had just diagnosed Ka’Miyah with RSV, a respiratory virus that infects the lungs and breathing passages. She stayed in the hospital for almost a week before making a full recovery and returning home to understandably protective parents.
“I’m very grateful for those officers. Officer DuChaine is a hero,” Tajanea says. “He was one of the first people we allowed to see our daughter after she came home from the hospital. He deserved that.”
As the holidays roll around, everyone’s looking for that special gift – something meaningful, worthwhile and of great value. Whether you’re shopping for new parents or grandparents, there’s one gift that works for every member of your family: the gift of CPR.
Considering 73.9 percent of adult cardiac arrests happen in the home, chances are your family members could save someone you all know and love. Every second counts in cardiac arrest, if performed immediately, CPR can double or triple the chance of survival from an out of hospital cardiac arrest.
The AHA’s Community Training Kits make a great gift choice, particularly the CPR Anytime program, which allows your gift recipients to learn basic lifesaving skills in about 20 minutes from the comfort and privacy of their own home or workplace.
Have soon-to-be or new parents in your life? Consider the Infant CPR Anytime Training Kits, which makes it possible for anyone to learn how to perform infant CPR and provide infant choking relief. This kit also makes a great gift for grandparents, babysitters, nannies and anyone who wants to learn lifesaving infant CPR and choking relief skills. The kit is co-branded with the American Academy of Pediatrics.
Consider Abby’s story. While in a dressing room trying on clothes, she heard a call come over the store’s radio saying there was someone who didn’t have a pulse and wasn’t breathing. Because she knew CPR, Abby raced to the scene expecting to see an elderly person, but instead found a mother and baby. Abby sprung into action and saved the baby’s life. “You never know when an emergency is going to happen and no one’s going to be there to help. I think anyone could do CPR, could learn that skill. It just gives you a great feeling inside knowing that someone else is living out the rest of their life because of you,” she says.
Another great option is the Adult & Child CPR Anytime Training Kits, which allow anyone to master the basics of adult Hands-Only CPR, child CPR with breaths, adult and child choking relief and general awareness of automated external defibrillators (AEDs).
Justin’s story really drives home the value of this course. On a Friday afternoon, 15-year-old Justin was playing in the backyard with a group of friends when a lacrosse ball hit him on the chest, in the exact location and at the exact millisecond of his heart’s rhythm, causing a condition known as commotio cordis. Thankfully, the kids called for help and a neighbor ran over to start CPR, which kept Justin’s blood circulating to vital organs until paramedics arrived. “This was such a freak accident, it could happen to anyone,” Justin’s mom says. “If our neighbor didn’t know CPR, Justin wouldn’t be here. I encourage everyone to take the time to learn CPR. You could save a life, maybe the life of someone you love.”
The AHA designed both of the kits mentioned in this story as self-directed, 20-minute personal learning programs and as an all-in-one solution that includes everything needed to complete high-quality training anywhere. Skills are taught with the AHA’s research-proven, practice-while-watching technique, which allows participants to practice on a manikin while observing a demonstration of the skills on video. A bilingual (English and Spanish) DVD and user guide come with every kit.
Your gift recipients can refresh their skills as often as needed and even pass along the kit to others once they’re finished with it, so it truly is a gift that keeps on giving.
As you get together with family and friends over the Thanksgiving holiday, ensure it’s a happy – and healthy! – time of year filled with positive memories. Here’s how.
Healthy Holiday Swaps in the Kitchen
This season, try the AHA’s five easy swaps in the kitchen. Don’t worry, all the flavor and festivity are still in the mix!
Use herbs and spices such as rosemary, rather than salt, on your turkey.
Choose lower sodium broth or stock to make gravy.
Whip up some mashed potatoes with low-fat or skim milk and soft tub margarine.
Season veggies with herbs and bake, grill or steam them – instead of frying.
Swap equal parts no-sugar-added applesauce for butter when baking.
Be Prepared for Minor Injuries: Cuts, Scrapes & Burns
With a houseful of rowdy kids or adults packed into a kitchen, you’ll want to keep overall safety top of mind. That means being well-prepared for minor injuries, including cuts, scrapes and burns.
Have a first aid kit on hand. Include adhesive bandages in a variety of sizes along with tape, gauze, latex gloves, antiseptic wipes, hydrogen peroxide, antibiotic ointment and hydrocortisone cream.
Also include some basic over-the-counter medications including ibuprofen, acetaminophen and antihistamines, as well as a thermometer.
Stash an ice pack or two in the freezer, or have the instant version on hand, for those unexpected bumps and bruises.
Take a Heartsaver First Aid CPR AED Course
Did you know that 74 percent of cardiac arrests happen in the home? Wondering what to do with a multigenerational houseful of family in the days before or after Thanksgiving? What better time to take a Heartsaver First Aid CPR AED course than over the holidays when everyone’s in town and together.
Heartsaver First Aid CPR AED is available in two different training methods, blending learning and classroom training. Both are geared toward anyone with little or no medical training who wants to be prepared for an emergency in any setting.
One more option to consider for the family: Heartsaver Virtual, a convenient training kit and app solution allows you the flexibility to take courses and complete a virtual hands-on skills session with an instructor 100% online.
Download the Free AHA CPR & First Aid App
Available for download on Apple Store or Google Play, the AHA has developed an array of apps dedicated to bringing science right into the palm of your hand. Check out the free CPR & First Aid App so you can be prepared to act in an emergency.
The app’s key features include easy-to-follow, step-by-step instructions for adults and children ages 10-plus, so get the kids involved too. Use it to learn CPR and first aid for some of the most common emergencies to occur not just during the holidays, but year round. The course covers choking relief, bleeding and bandaging, heart attack, seizures, Hands-Only CPR, CPR with breaths and much more. The fun and informative format includes video, animations quizzes and games for the whole family.
On a crisp mid-September evening in Forest Lake, Minnesota, Kristina Thill was helping with the annual fall festival at the church where she grew up. After she finished her shift at the kids’ game booth and started chitchatting with a friend, she noticed an elderly church member stumbling out of the building.
“We were like … okay, well, that was kind of weird. He doesn’t really look like he’s doing too well. So we walked over to him and asked if he was okay, and he said thatsomething didn’t feel right. That’s when he collapsed,” Kristina says. She and her friend caught him as he fell to the ground and stopped breathing. They yelled for help and a police officer rushed over and began to administer CPR. At that point, Kristina handed her phone to a bystander and asked them to call 911.
“Because I work at the school and church, I knew where the AED machine was. So I ran and grabbed it,” Kristina says. “When I initially got back to the scene, the police officers stopped CPR to help with the AED. I kind of pushed them back and said, ‘Nope, I’ve been trained. Continue with CPR, and I’ll get him hooked up.’”
Luckily for everyone involved, Kristina had taken a couple of American Heart Association Heartsaver First Aid CPR AED classes from a local provider called Heart & Soul. Her most recent class was just three weeks prior to this event and the instructor, Cindi Gervais, knew to go over where to find the AED, even though some in attendance already knew where to find it.
“I hooked him up to the AED machine, and it said to administer a shock,” Kristina remembers. “We pushed the button and brought him back. He started coming around and talking.”
By that time the EMTs had arrived, assessed the situation and requested a helicopter to take the man to a major hospital. Kristina’s mom works for the church and does all of the hospital and home visits, so she was able to get in touch with the hospital to learn the man had survived. He bounced back quickly and continues to volunteer at the church and school.
The training Kristina received not only gave her the knowledge she needed to play an important part in the rescue, it gave her the confidence she needed to help save a life.
In Calcasieu Parish, Louisiana, sits the Lake Charles plant of LyondellBasell, one of the largest plastics, chemicals and refining companies in the world. On one hot August morning, Safety Engineer Chris Chaisson went about his usual routine. “There was nothing really special what was going on that day. We were just making our rounds through all the security stuff, just checking things, seeing how people were doing and if there were any issues,” he says.
That’s when the call came in: “Man Down!” As Chris raced to the scene, he got word that EMS had already been dispatched, so he started delegating important tasks to those he encountered along his way: Go to the road and flag in the ambulance. Take the keys and open the guard gate. Guide the ambulance to come straight in and back up to the scene.
“As soon as I walked up to the patient, everyone backed away. It was a strange feeling like I had some kind of specialized training that they didn’t,” Chris says. “That was a little different than what I would have expected. I would’ve expected to help, not be expected to lead.”
As the crowd parted, Chris saw a CPR and AED-trained maintenance supervisor using an AED to analyze the heart rhythm of the patient, one of the site’s millwrights responsible for maintaining the plant. The AED provided instructions on how to proceed. About the same time that EMS arrived, so did Dawn Hinton, the on-site nurse practitioner, and Amanda Hebert, the security account manager for the site.
“EMS allowed the three of us to rotate as we continued to provide CPR,” Chris says. “They believed we were doing a good enough job, where they didn’t even take over.”
Eventually, the AED stopped recommending shocks. “We got a good rhythm on him, got him stabilized and into the ambulance,” Dawn says. At the hospital, it was no surprise when doctors determined the patient had gone into cardiac arrest. The next day they implanted stents to correct a left main artery almost 100 percent blocked. After a few days, the hospital released the patient to a very appreciative wife.
“The beautiful thing about this scenario is the amount of response we had,” Chris says. “We probably had a dozen people who were involved overall.”
Left to right: Amanda Hebert, Chris Chaisson, and Dawn Hinton
He offers a valuable reminder. “These medical emergencies can happen anywhere, anytime. Having the ability to respond is everything, like in our situation, as soon as we walked up everyone drew back. They expected us to do something about it. So you might find yourself in a situation in which you’re viewed as the leader of the response. You want to be prepared.”
The plant offers CPR training on a regular basis for its electricians, supervisors and others who want lifesaving education. “The most important thing is having multiple trained, responders on site and an AED that’s readily available,” Chris says. Within less than three minutes, employees had the AED on the patient and were performing CPR.
“Those cycles of giving compressions and resting were so important to us because that allowed us to have the bench strength to recover. Providing quality CPR takes a lot of energy. The ability to have three to five people able to rotate in and out made all the difference,” Chris says. “We had all the help we could ask for. It was a picture perfect response.”
As a graduate student at Johns Hopkins University, Guy Knickerbocker, PhD, was one of three researchers who developed cardiopulmonary resuscitation, also known as CPR, which has saved countless lives.
Guy Knickerbocker, PhD
He died June 21, 2022 in Narvon, PA. He was 89.
Knickerbocker was an electrical engineer and doctoral student at Johns Hopkins University where he collaborated with William Kouwenhoven, PhD, also an electrical engineer and professor, and James Jude, MD, a cardiac surgeon and resident at The Johns Hopkins Hospital, to develop the prototype of the first portable external defibrillator in 1957.
A year later, Knickerbocker made a crucial observation while working with Kouwenhoven and Jude. He discovered that pressure on the chest during defibrillation experiments in animals produced an arterial wave form and a temporary rise in blood pressure. This observation paved the way toward a new technique, which is now known as CPR.
The team published their research breakthrough on the value of external cardiac massage in providing blood flow to vital organs for people in cardiac arrest in the Journal of the American Medical Association in 1960.
“Anyone, anywhere, can now initiate cardiac resuscitative procedures,” the researchers noted in the landmark paper. “All that is needed are two hands.”
From left to right: Drs. James Jude, William Kouwenhoven and Guy Knickerbocker are regarded as the “Fathers of CPR.”
The brilliant trio would come to be regarded as “the fathers of CPR.”
In the early 1960s, Knickerbocker also collaborated with others to produce the training film titled, “Pulse of Life,” which was viewed by millions and popularized CPR.
Throughout his career, he published over 30 articles about electricity and the human body, according to his obituary.
William Montgomery, MD, FAHA, who serves as the coordinator for the International Liaison Committee on Resuscitation (ILCOR), said Knickerbocker will always be remembered for his incredibly important work in the laboratory and in training activities.
Montgomery first met Knickerbocker at an AHA National Conference on CPR and Emergency Cardiovascular Care (ECC) in 1985 when Knickerbocker was among the first group of “Giants” in resuscitation science honored by the AHA for their landmark contributions to CPR and emergency cardiovascular care.
Left to right: Drs. James Jude, Guy Knickerbocker, Peter Safar and James Elam were among the first group of “Giants” in resuscitation science honored by AHA in 1985 at the organization’s National Conference on CPR and Emergency Cardiovascular Care (ECC).
Montgomery said in recent years, Knickerbocker and his wife, Joan, attended the Citizen CPR Foundation’s Emergency Cardiac Care Conference (ECCU), where he met with cardiac arrest survivors who were saved because of his breakthrough research.
“Those survivors were so happy to meet with him in person and individually and take pictures ‘with the man who invented the technique that saved their lives,’ Montgomery recalled. “These were very warm and emotional meetings and Guy was always very gracious with everyone.”
It was during the ECCU events where Dianne Atkins, MD, chair of the AHA ECC Committee, would meet with Knickerbocker.
“He was always a very pleasant man and willing to have his picture taken with everyone who asked,” Atkins remembered. “He seemed quite humble about his accomplishments with respect to CPR, but also was quietly proud of them.”
Atkins said it is now known that immediate CPR, usually delivered by a lay rescuer, is a primary determinant of survival with good functional outcome. Yet, she said less than 50% of patients in cardiac arrest in the U.S. receive CPR before EMS arrives.
Dianne Atkins meets with Guy Knickerbocker at the ECCU event in 2017.
“The AHA and the ECC need to commit to better understanding how to engage the lay public in understanding the need for CPR, improve the percentage of those who receive lay rescuer CPR and to ensure that our teaching methods are the most effective for providing high-quality CPR,” she said.
Knickerbocker and his research team fundamentally changed the way in which patients with cardiac arrest are treated, said Comilla Sasson, MD, vice president of ECC Science and Innovation at AHA. To continue his legacy, she said that the AHA is committed to teaching CPR to everyone.
“The American Heart Association is dedicated to making sure every person knows how to perform CPR, and can help save a life,” Sasson said. “And that all people, regardless of where they live or what healthcare system they are treated in, will have an equitable chance for surviving a cardiac arrest event.”
Another major way that Knickerbocker’s legacy can endure is for AHA and ILCOR to continue to support innovative research, said Robert Neumar, MD, who co-chairs ILCOR.
“We need to advocate for greater investment in resuscitation science and expand the pipeline of young scientists entering the field,” Neumar said.
Montgomery said Knickerbocker will always be remembered as being one of the original scientists and investigators that discovered modern CPR as we know it today.
“Even though he has passed, he will aways live in the hearts and minds of all providers of CPR and survivors as a ‘Giant’ in resuscitation and the person responsible for discovering the technique that ‘saved my life,’ Montgomery said.
Local cardiac arrest data informed Lynn Blake’s strategy to determine AED locations that contributed to a timely save
Last July, Doug Schwartz was enjoying dinner with his girlfriend, Shelly Belknap, and a friend at eTown restaurant located in Edwards, Colorado when he began to feel faint, and he suddenly suffered a cardiac arrest.
Shelly, who is an oncology nurse at Vail Health, was sitting next to Doug and immediately started CPR. Stephen McGaffick, an employee at eTown who is also a Beaver Creek Ski Patrol member, took turns with Shelly and performed CPR on Doug.
Fortunately, an automated external defibrillator (AED) was located about 100 yards away outside in a heated box attached to a lamppost in the Riverwalk, which is Edwards’ downtown area.
The AED that was used to help save Doug’s life was in this heated box attached to the lamppost.
A restaurant patron named Megan went to go grab the AED. When Megan returned with the AED, Shelly and Steve applied the device, which delivered two shocks by the time the paramedics arrived.
The paramedics took over and helped revive Doug. The restaurant patrons, who anxiously waited for an update on Doug’s condition, erupted into applause once they heard that he was alert.
Doug was transported by ambulance to Vail Health Hospital and then transported by helicopter ambulance to Denver that night. He spent five days in the ICU at Medical Center of Aurora and was then discharged.
Placing AEDs in key locations can make the difference between life and death. A person’s chance of survival decreases by 7 to 10 percent for every minute that passes without defibrillation.
The AED used to help save Doug’s life was one of more than 100 devices that had been strategically placed throughout Eagle County, Colorado about seven years ago thanks to the efforts of a local resident named Lynn Blake, a strong advocate for public AED implementation programs and quality improvement initiatives for cardiac arrest outcomes.
“I was flooded with emotions for a man I never met,” Lynn said when she learned that Doug’s life had been saved thanks to CPR and the use of the AED. “He was the reason I devoted so much of my life to implementing these programs, it was all for this man and his family.”
Lynn’s journey with advocating for the AED program in Eagle County traces back to her own personal story as a cardiac arrest survivor.
Surviving a Cardiac Arrest Spurs CPR and AED Advocacy Work
The start of 2007 was a whirlwind for Lynn. She got married on Feb. 3 and went on her honeymoon two days later. As soon as she returned from her trip, she began a new job in Vail, which is also located in Eagle County.
On Feb. 14, 2007, Lynn, 27, was on the second day of her job when she suddenly experienced cardiac arrest. One of Lynn’s co-workers, Sue Froeschle, whom Lynn hadn’t even met yet, immediately started CPR while another employee called 911 and ran to get help from the Vail Fire station that was across the street. Eagle County paramedics were also nearby; they quickly arrived and used a defibrillator to deliver three shocks to her heart.
(Left to right): Lynn Blake holds her baby, Thomas, with her rescuer and friend, Sue Froeschle
Lynn survived the incident and now has an implantable pacemaker defibrillator. She finally met Sue a year later when the American Heart Association gave an award to the first responders who helped save Lynn’s life. After the event, Lynn and Sue became very close. Her son is even named Thomas Froeschle Blake.
“There were so many coincidences and ironic details that allowed me to survive – I felt so compelled and convinced that my life was saved for a reason,” Lynn said.
Lynn didn’t know anything about cardiac arrest before the incident. She started researching to learn more about the condition. She also became an American Heart Association CPR instructor so that she could teach others how to save lives.
Throughout those early days of investigating, Lynn learned that cardiac arrest is a leading cause of death in the U.S. Yet, she was confounded that she couldn’t find any data on incidences and outcomes anywhere.
“No one could tell me who experiences cardiac arrest in Eagle County or even Colorado,” she recalled. “I could not find any information that was truly validated. Everything was an estimate.”
It wasn’t until she read a book titled, “Resuscitate,” that she learned about the Cardiac Arrest Registry to Enhance Survival (CARES), a quality improvement program that works with EMS communities to collect data and measure out-of-hospital cardiac arrest outcomes.
After connecting with CARES and learning more about the program, she worked with local health authorities and volunteers to secure funding so that Eagle County could participate in the registry starting in 2014. She then worked with officials to get the state of Colorado to participate in CARES in 2019.
Lynn said it’s imperative to track how bystanders and EMS are responding to cardiac arrest to identify the necessary intervention strategies that will optimize the chain of survival.
“I can’t say ‘you need to learn CPR and have an AED’ if we don’t know if people are performing CPR and using AEDs,” she said. “It’s impossible to improve resuscitation outcomes if you don’t know what you’re improving. Data collection allows not only the community to figure out how citizens should be engaged, but also gives agencies a way to measure their performance. Quantitative analysis of cardiac arrest is the linchpin to successful resuscitation, and it must happen for the conversation to continue.”
Using Data to Guide AED Placement in Eagle County
Out-of-hospital cardiac arrest (OHCA) is a global public health issue experienced by 3.8 million people annually. Only 8% to 12% survive to hospital discharge. Early defibrillation of shockable rhythms is associated with improved survival, but ensuring timely access to defibrillators has been a significant challenge.
Public-access defibrillation is the use of AEDs by the public to facilitate CPR and early defibrillation before professional responders arrive. A recent International Liaison Committee on Resuscitation (ILCOR) scientific statement commissioned by the American Heart Association evaluated the barriers to public-access defibrillator use and early defibrillation. The statement titled, “Optimizing Outcomes After Out-of-Hospital Cardiac Arrest With Innovative Approaches to Public-Access Defibrillation,”also identified the opportunities for new approaches to public-access AED program implementation.
Public-access defibrillation has saved many lives. Unfortunately, public-access AEDs still remain underused. The devices are used in less than 3% of OHCAs.
However, people who experience OHCA with a nearby AED are three times more likely to receive bystander defibrillation and twice as likely to survive as those without an AED nearby, according to the statement. Unfortunately, AEDs are rarely close enough for timely retrieval. The issue is further compounded by the fact that even when a registered AED is near a cardiac arrest incident, most go unrecognized and unused. The ILCOR statement calls for using innovative approaches to improve public-access defibrillation in the future by optimizing AED availability, reliability and usability through coordinated, data-driven, regional strategies.
When Lynn worked with officials in various Eagle County communities to place the more than 100 AEDs, it was important to them that the devices were easily accessible and not placed behind locked doors like they had typically been in the past.
However, she said there was some initial reluctance among entities to place public defibrillators, especially outside and unsecured. She said the entities feared liability, theft, people using them unnecessarily, and freezing temperatures.
Through education efforts, Lynn helped the entities understand the crucial need for AEDs by sharing statistics and the fact that theft is fairly uncommon. She worked to ensure that the AEDs were placed outside in heated boxes attached to lamp posts where they’d be available 24/7.
Additionally, the ILCOR statement discusses the value of geographic cardiac arrest data to inform AED placements such as density maps of OHCAs that plot incidences on a map that can pinpoint higher-risk spots for cardiac arrest and prime locations for AEDs.
Using data from CARES, Lynn said AEDs were placed in the most common public locations for cardiac arrest emergencies such as healthcare/nursing home facilities, schools and libraries throughout the county. Then, the most highly-trafficked public places were identified using Eagle County’s geographic information system and Google maps. Lynn said it wasn’t realistic to place a unit in every small business, plus the lifesaving devices needed to be accessible 24/7.
“This started the outdoor cluster approach, installing heated cabinets to light posts in the most centrally accessible points to multiple establishments,” she said. “Deploying one unit for numerous places significantly diminishes the cost and increases accessibility. “
Lynn said she worked with her neighborhood of EagleVail to install defibrillators at major residential and golf/Nordic course intersections because CARES data suggests that residences are the most commonplace for cardiac arrests to occur.
“Hopefully, someday in the near future, defibrillators will be as common as microwaves in homes,” she said. “Until then, we must continually strive for the ubiquity of these lifesaving devices. There is so much more that can be done, but working from the grassroots up is very difficult. Federal mandates and more awareness must occur to achieve the availability needed.”
‘It Took a Village to Save Doug’
Left to right: Doug Schwartz and Lynn Blake at the coffee shop.
In December, Lynn and Doug met for the first time at a coffee shop.
“I was very grateful,” Doug said. “That is what I tried to communicate to Lynn in my meeting. It is strange to sit across the table from somebody who played a part in saving your life.”
He said he feels very fortunate with the way the events unfolded last July from receiving high-quality, immediate CPR from Shelly to Megan grabbing the AED nearby.
“I don’t know how you could draw up a plan any better with the timeliness of my save,” he said.
For Lynn, it was a dream come true to meet Doug whose life was saved with the help of an AED program that she and other volunteers developed after she received a second chance at life. It’s also a testament to the chain of survival that improved once the community started tracking and measuring data to make changes that save lives.
“It took a village to save Doug,” she said. “There are so many components that have to take place to save one life.”
On a Friday afternoon, just an hour or two before he’d clock out for the weekend, Deputy Sheriff Jason Roy patrolled the outer perimeter of the Berkshire County Jail in Pittsfield, Massachusetts.
“I happened to have our county dispatch radio on and was just listening to calls come in,” Jason says. “On one particular call, I heard the address given: 465 Cheshire Road. I was at 467 Cheshire, literally seconds from that location.”
Then came the details: One vehicle accident. Airbags deployed. Unconscious operator.
Jason immediately headed in that direction, hoping to do what he could — maybe help direct traffic — while the fire department, EMTs and police worked the scene. But he arrived to find three bystanders pulling a man from a car. He was unconscious but breathing. Jason put his car in park as he directed the bystanders to roll the man on his side, in the recovery position.
That’s when everything changed.
“He’s not breathing anymore,” yelled the bystanders.
They rolled the man on his back and ripped open his shirt knowing that an AED was on its way.
“He’s gray and there’s no pulse,” Jason says. He begins compressions and thinks to himself, I’m going to give you compressions until you’re a pancake or you come back. You’re not going to die, you’re going to live. You’re not going to die on me right here. This is not how it’s going to happen. There’s no way.
“I’ve never done this before, responded to this type of situation where I’ve had to do CPR. This is my very first time,” he says. But it’s what he has done that makes all the difference. “I’ve had 21 years of CPR training. Every year all of our employees at the Sheriff’s Office, whether we’re uniformed or civilian staff, have the same exact CPR training, the American Heart Association’s Basic Life Support program.”
The fire department and EMTs arrive and begin administering shocks using the AED.
“I’m standing just beyond them, and I look up and see the Assistant Deputy Superintendent of our training, then I see our Sheriff behind him,” Jason says. “They saw the training in action. This is what we do on paper. This is what we do in the classroom with our CPR training, manikins and training AEDs. All of the scenarios that we practice and drill for is so that at moments like this we can have the best possible outcome.”
That’s what they got in that moment, the best possible outcome. As they loaded the man on the ambulance, Jason quickly popped his head in and asked an EMT, “Is he breathing?” Not only was he breathing, the EMT said, but they had gotten a pulse. Off they went to the hospital.
The Fire Chief said to the Sheriff, “Wow, because of your officer’s response, those early compressions and CPR, that’s why that man’s breathing right now. That’s why we got him back.”
In retrospect, Jason remembers that during his CPR classes the instructors always said, “When you actually have to respond a call, you’re going to revert to your training. What you’re doing here in the classroom — what you practice; what you read; the physical, real application tests you take with the manikins and the AED — you’ll flip that switch and do it.”
But after 20-plus years of sitting in a classroom and hearing that, Jason began to wonder, What are the chances of this happening to me?
But when his time came, he learned the instructors were right. “It just clicked. There was never any doubt. I knew what to do. I just flashed back to the training,” he says.
In the days that followed the congratulations poured in, some from coworkers and colleagues who had listened to the radio call in real-time. Then came a formal Commendation from The Commonwealth of Massachusetts, Berkshire County Sheriff’s Office that read, in part, “Your vigilance, situational awareness and adherence to your training undoubtedly saved the life of this individual.”
“I did what anybody else who would have heard that call or driven by that scene would have done if they were a Sheriff’s employee. I’m confident they would have pulled over, even if they didn’t have a radio, even if they were off duty or just a civilian,” Jason says. “That’s what we do at the Sheriff’s Office here. Every one of our employees could have done, and is trained to do, what I did.”
