History of CPR

Six cardiologists meet in Chicago and form the American Heart Association (AHA) as a professional society for physicians. Nearly a century later, the AHA will be the world leader in CPR and emergency cardiovascular care (ECC) training and education.

This blog entry is based on content from a podcast interview with Karl Kern, MD, Mary Beth Mancini, RN, PhD, and Raina Merchant, MD, MSHP, titled AHA’s History of CPR.

Dr. Raina Merchant:  Can you tell us a little bit more about what CPR actually is?

Dr. Karl Kern: CPR is simple a technique to provide blood flow to the organs of the body when the heart’s not doing its job. It often gets confused with a heart attack. A heart attack can cause cardiac arrest, but it’s actually the step where the heart no longer is pumping forward blood flow. That can happen either because it stops beating. It has no heartbeats that are effective, or it can actually go too fast or quiver in what’s called ventricular fibrillation. The result is the same. No flow and the organs, particularly the brain, begin to suffer right away. One falls unconscious and if not treated, it’s clearly a mechanism that will lead to ultimate death.

Dr. Beth Mancini:  When we think about cardiopulmonary resuscitation, we often think about the American Heart Association. Perhaps you can tell us a little bit about the history.

Dr. Karl Kern: The American Heart Association is well known for its involvement with cardiopulmonary resuscitation. CPR really had its beginnings in the late ’50s, early ’60s. Prior to that time, if you had heart stoppage or cardiac arrest, the only real treatment was to open up your chest, put your hand in there, and actually squeeze the heart directly to create some blood flow. Obviously that has limited applicability. So in the late ’50s, early ’60s, the discovery was made that by pushing on the chest, you could create some flow. It’s not a normal amount of flow. It’s not what you’re used to, but it’s enough to keep the most important organs of the body alive, particularly the brain and the heart so that the heart can respond to further treatment and begin to beat on its own.

The real excitement was really started in Baltimore at Johns Hopkins where, during an experiment to try to shock the heart, they noticed when they pushed hard to make sure the paddle had good contact, they could see a little bump in the aortic pressure. When they pushed rhythmically, they could actually produce blood flow that would, again, help the heart, help the brain, and keep those two vital organs viable.

It began with compressions and then actually people began to think, “Well, we need to replenish the oxygen.” So the concept of ventilation interposed with the compressions was introduced. Again, for the lay public, mouth-to-mouth breathing. The two were married for several decades as the way to do CPR. The problem was that in some communities the citizens were simply not willing to do that form of rescue. Whether it was fear for disease, transmission, or whatever, certainly the aesthetics of mouth-to-mouth contact with a stranger was an impediment. So a number of centers, including where I am at the University of Arizona, we began to wonder, “Well, how important is the breathing part? What’s the key component to save a life, even if you have some price to pay?” So we began to explore compressions only, or hands-only as it’s now called by the American Heart Association. This is not true for children whose arrest is often first precipitated by respiratory problem, but for witnessed adult who collapses in front of you, that compressions only was very helpful and probably enough for those first 10 to 15 minutes. And then clearly as sooner or later you must do some breathing and replenish the oxygen.

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.


CPR Training is a Routine “Exercise” that Could Save a Life

Today’s blog speaks with Brandon Head, owner, Grapevine CrossFit in Grapevine, Texas regarding his experience when a cardiac arrest occurred in his facility.

Brandon, thank you so much for speaking with us. Would you tell us what happened?

It was a routine Friday. My facility is located close to DFW Airport, so we frequently see drop-in traffic from airline employees who don’t live in the area but who fly in and out and need a place to exercise while they’re here.

A pilot had come in that morning; we’d seen him a couple of times before during his travels. One of my coaches, Jordan, was watching him as he worked through the workout for that day. Everything seemed normal, and he finished the workout without issue. But, as he paid Jordan for his workout, he collapsed suddenly to the floor.

I heard his fall and turned. I rushed over and it was immediately apparent that this was not a case of passing out from over-exertion. He was having a cardiac arrest. As I ran to get the gym’s AED while calling 9-1-1, I yelled for our staff physical therapist, Dr. Matt Taylor, to come with me back to the patient.

Matt rolled the victim onto to his back. He was not breathing and was without a pulse. After a shock from the AED, Matt then performed two rounds of chest compressions and rescue breaths. At that point, the patient took a gasping breath and woke-up. He even tried to stand, disoriented and confused. We heard the sirens just then as the EMS arrived.

The total time was less than five minutes; it felt like forever.

After EMS took him away, do you know his outcome?

Jordan and I did go to the hospital to visit him. We learned that he had had a 90% blockage in his left artery, and the doctors fitted him with two stents. He was very appreciative for our actions, and he even came back in to the gym to thank us after he was released from the hospital.

As is often the case, he doesn’t remember anything in between the time of payment and the EMS standing over him.

Is your team trained in CPR?

Our gym requires staff CPR training, and the American Heart Association (AHA) is who we use. We purchased the AED four years ago as a precautionary decision, after one of AHA’s trainings. This was the first time that we have ever deployed it—and I can now testify that it is worth the investment.

The quality of the training the AHA provided my team was very in-depth. Having never been in that kind of situation before, I do believe that it made a difference in our quick response. Because of what happened, I’ve decided to raise awareness with other businesses in our community about the importance of training and having an AED on-site. This kind of incident can happen anywhere, not just at the gym. If you’re a company that cares, have a process in place so that you know what to do when needed. Learn more about AEDs at www.heart.org/AED.


From the Hospital to the Local Gym, Lifesavers are Everywhere

Karen Yates is the Chest Pain Coordinator and EMS Liaison for the Methodist Mansfield Medical Center in Mansfield, TX. She has nominated nurse Tai Tran for the American Heart Association (AHA) Heartsaver Hero Award for his quick actions to save a life this past December. The CPR & First Aid Blog sat down with Karen to learn more about her story:

Question: Karen, tell us what happened.

Answer: It was December 27, 2018, and the patient in question, Don, was at a local Lifetime Fitness gym here in Mansfield. Don had finished with his workout and had just entered the locker room when he fell in cardiac arrest. 

Fortunately for him, a nurse from Methodist Mansfield Medical Center, Mr. Tai Tran, had walked in right behind him, saw him collapse and began CPR immediately. While Tran performed CPR, other patrons called for gym employees and dialed 9-1-1. Thankfully, the employees at the gym were well-trained and quickly responded with an AED, which they used to defibrillate Don twice. The immediate and effective care Don received from Tran and the Lifetime employees worked, and he was awake and talking by the time EMS brought him into the hospital.

Q: Now what role did you play?

A: Through an app on my phone, I stay connected to the local fire department’s dispatch while I’m on duty. When the call for Don came in, I was able to alert our emergency room that a cardiac arrest was arriving soon so that they could prepare for an imminent reception. We were ready and waiting when the patient arrived.

I went outside to greet the ambulance, and I recall asking Don, “How do you feel?” “A little tired,” was his response. Well, that’s to be expected! 

Q: What’s his outcome now?

A: Thankfully, I can report that Don has been discharged and is at home recovering with his family. I’ll add that Don and his family clearly understood that this story could have had a very different outcome had the right people not been around. The impact of that isn’t lost on anyone, and the gratitude everyone shares for this happy ending has been deeply felt by all of us.

I nominated Tai Tran for the AHA’s Heartsaver Hero Award because he is an ideal example of how quality CPR training and quick action can save a life no matter where you are.

Q: What is your affiliation with the American Heart Association? And why AHA?

A: Our hospital recognizes the AHA’s training, such as BLS and ACLS. It is required continuing education. I’m actually an instructor and have had a long-time relationship with the Association. I also participate in Mission: Lifeline in North Texas as well as participating in the AHA’s Speaker’s Bureau.

From a personal perspective, I feel that the AHA’s mission is clear and its curriculum comprehensive. In terms of cardiac care, the AHA sets the gold standard. It’s as simple as that.


Mom Always Knows Best: Mother saves daughter’s life performing Hands-Only CPR

This blog was noted by interviews from Jenna Coleman and her mother, Kathy Golden, a victim and rescuer of cardiac arrest.

“The only thought running through my head was to keep Jenna alive until help arrived,” recounted Jenna’s mother, Kathy Golden. “I recalled the training I had in CPR and quickly went through the steps I was taught. I was not going to let my child die.”

Cardiac arrests occur when the heart suddenly stops beating. Each year, over 350,000 cardiac arrests occur outside of the hospital and about 90 percent of victims don’t survive. CPR, especially if performed immediately, can double or triple a cardiac arrest victim’s chance of survival, according to the American Heart Association. The two steps to Hands-Only CPR are to call 9-1-1 (or send someone to do that) and push hard and fast in the center of the chest.

“I woke up to my mom screaming at me,” says Jenna as she looks back on the day she went into cardiac arrest.

On January 1, 1999, Jenna Coleman woke up with the stomach flu. Her body had been used to the flu-like symptoms, as she has had a pacemaker since she was 9 years old and would typically deal with illness around the same time of year. Nothing seemed unordinary, until she lost consciousness.

When a person has a cardiac arrest, survival depends on immediately receiving CPR from someone nearby. As of April 2019, only about 46% percent of bystanders perform CPR. Most out of hospital cardiac arrests occur in the home – about 70%. Nearly 45 percent of out of hospital cardiac arrest victims survived when bystander CPR was administered.

“As a mother, losing your child is the worst possible thing that could happen. I realized that knowing CPR and knowing what to do saved my child’s life,” said Kathy. “Trust your instincts and training. CPR works and you can save a life.”

Since the incident, Jenna and her mom have made it a point to advocate for a healthy living style. They both are actively involved in volunteering at their local American Heart Association office, participating and raising funds for events like Kids Healthy Heart Challenge and Heart Walk, and they are consistently learning and teaching the benefits of Hands-Only CPR. The importance of being healthy, maintaining exercise and being CPR trained has became second nature for the whole family.

“People can improve their health by just making one small change. Those small changes can add up over time and make a huge impact on your overall health. Instead of drastically changing your diet, try switching to whole grains and reducing your sodium intake. Switch from soda or diet-soda to water or sparkling water,” suggests Jenna. “Small changes can make a huge impact to keep you heart healthy for good!”




Calm During the Storm: Off-Duty EMT Saves Baby’s Life With CPR

Awakened from a deep sleep by a frantic father, EMT’s strength of mind and skill prevails

When Brent Cinberg was awakened by screaming and a loud knock at his door at 4:45 p.m. on  Sept. 8, 2017, he had no idea what to expect. An EMT for the EMS Division of the Elizabeth Fire Department in Elizabeth, New Jersey, Brent worked nights and usually slept from 9 a.m. until 4 or 5 in the afternoon.

When a pajama-clad Brent opened his door in a sleep-filled haze, he was stunned to see his neighbor holding his 3-month old daughter, who was cyanotic and essentially lifeless. Several other neighbors flanked the terrified father, who handed his daughter to Brent, begging him to save her.

The Elizabeth EMS team doesn’t perform pediatric CPR on a daily basis, and Brent himself hadn’t worked on a child in over a month. He also lacked the usual resources. “I had nothing,” he said. “No backpack and no partner. So I immediately went through the textbook steps in my mind and told my neighbors to call the cavalry.”

An engine arrived first, allowing Brent to put the baby on oxygen while continuing CPR. In less than three minutes, his coworkers arrived via ambulance. Brent placed the baby on a stretcher while describing to paramedics what had transpired. Still critical, the baby was transported to a nearby hospital. Once stabilized, she was transferred to a specialized children’s hospital for further treatment. Today, thanks to Brent’s intervention, the child is healthy with no long-term cognitive deficits.

How was Brent, who was awoken from a deep sleep, able to remain calm enough to treat the child while surrounded by frantic neighbors? First, a sense of calmness was instilled in him from an early age. His father is an ear, nose and throat surgeon, and his mother, a teacher, is also a volunteer firefighter. Brent was also a lifeguard as a teenager. “Because of all of that, I think I have a better sense of being calm in tense situations than the average Joe,” he said.

Ultimately, Brent said, it came down to confidence in his training. “I’ve done so many calls and have seen for myself that CPR works,” he said. “So when I was in a situation that wasn’t run-of-the-mill like this one, I was prepared because I believed in my training.”

Brent encourages everyone to have at least a basic knowledge of CPR. “The more people who can perform CPR, the better it is for society as a whole,” he said. “It’s one of those things in life that you don’t necessarily think you need until you do — but then you’re so happy that you took the time to learn something that can be so powerful.”






Tragedy Transformed: Nurse Turns Teenage Loss Into Life-Saving Opportunity

Nurse uses CPR to save a teen who experienced sudden cardiac arrest at a track meet

Click here to watch the full story

Angie Knannlein-Rahman was a high school senior when a soul-crushing event changed the course of her life. She and her friend Adrienne were jogging during volleyball practice when Adrienne commented that she felt a sudden head rush, hitting her head as she dropped to the ground. Angie yelled for help, holding Adrienne as she gasped for air.

“I thought that hitting her head was her biggest problem,” said Angie. “It never crossed my mind that her heart had stopped.” Their coach performed CPR, but Adrienne ultimately passed away, three days after her 16th birthday. “Adrienne sustained a brain injury because we didn’t help her fast enough, and I carry that with me,” said Angie. “We lost precious moments that day.”

When Angie returned home from school the day of Adrienne’s cardiac arrest, she relayed to her mom the feeling of helplessness she felt while holding Adrienne in her arms. “My mom told me that maybe I was meant to be someone in action who could help, like a nurse,” said Angie.

She took those words to heart, and today, Angie is a registered nurse at Mercy Health ‒ St. Charles Hospital in Oregon, Ohio. And when her life-saving CPR skills were needed at a recent track and field event where she’s also a coach, Angie didn’t hesitate to act.

Adam, a 17-year-old athlete, experienced sudden cardiac arrest during the event. He was turning blue as Angie, along with another nurse and a physician assistant, began chest compressions while waiting for the automated external defibrillator (AED) to arrive, which took seven to 10 minutes because trainers were unsure of its location.

With the use of the AED, Adam began to regain consciousness and fully came around in the ambulance. Many event attendees were surprised that an AED was on-site. “We need to improve the culture of understanding the important role that AEDs play,” said Angie.

Angie’s journey as a nurse and being able to help save patients like Adam has brought her full circle from Adrienne’s passing. It’s something she thinks about often, particularly when she renews her ACLS and BLS training through the American Heart Association. “You are beating someone’s heart for them, and that’s such a tremendous responsibility,” said Angie. “If you’re going to do it, you have to do it correctly. This situation — to get to see Adam have a life, be healthy and flourish from that — is a reward that I can’t even explain.”

Are you a nurse? Send us your save stories to monica.sales@heart.org


CPR Training as a Business: How being her own boss affords one trainer her best life

American Heart Association instructor Tamara McLaughlin owns and operates her own training business in Vermont. The CPR & First Aid Blog sat down with her to chat about how she does it.

Q: Tamara, what is your background?

A: I began my career training medical assistants across Maine, New Hampshire and Vermont 24 years ago. One day, my boss informed me that I would start training physicians in CPR, which at that time I knew nothing about! It was intimidating, but I went through the classes and became an instructor with the American Red Cross.

After a couple of years, I decided to teach American Heart Association coursework instead because I felt it gave a better understanding of high-quality CPR. Once I switched, the feedback I received from my students was overwhelmingly positive. That’s when I knew that I was on to something and decided to go into business for myself.

Q: Would you tell us about your business journey?

A: My company is called VT SafeyNet Inc., and I teach the Association’s BLS and all Heartsaver courses, including Heartsaver First Aid, CPR AED and Bloodborne Pathogens. I began simply: I designed and printed my business cards and mailed them to local doctor and dentist offices that had smaller staffs, which meant they were likely to not have internal training. This was a side job for more than 10 years, but eventually through networking at trade shows and client referrals I began to be hired by larger firms with regular needs. That’s when I switched to doing this full-time.

I’ve been working for myself full-time for nine years now; I train about 2,500 students a year. It works best for me because that it allows me to set my own hours and, as such, I’m able to strike that work-life balance. I feel like I’m leading my best life.

Q: What do you believe is the secret of your success, so to speak?

A: I emphasize being enthusiastic, engaging, and utilizing humor to make the material less intimidating. I train people from all walks of life—from construction workers to hospital Chief Medical Officers. The most important thing is to customize my delivery of the material to serve how each person learns.

Q: Finally, tell us why the American Heart Association is your choice?

A: The Association teaches the science behind its material. When students ask me questions in class, I want to be able to fully answer them as opposed to providing routine talking points. The Association provides you everything you need to know. For my business, this put me miles ahead.

Thank you, Tamara, for speaking with us and for being such a dedicated American Heart Association advocate!


Coffee, Croissants, and CPR: Quick action from bystanders saves a life in Pennsylvania

Coffee, Croissants, and CPR
Quick action from bystanders saves a life in Pennsylvania

For Stacey Sassaman and Lloyd Emelle, it was a day like any other. They were visiting Stacey’s brother in Westchester, PA and decided to spend a quiet afternoon at the neighborhood coffee shop. The two took up seats next to an elderly man who seemed to be sitting and quietly daydreaming to himself. After a while the man, Joe, fell asleep in his armchair. Stacey, a medical student, noticed his sleep seemed erratic and his breathing uneven, so she and Lloyd opted to keep an eye on him.

Almost an hour later, Joe’s breathing appeared to be getting heavier and he was struggling. “At this time we were increasingly concerned about his symptoms,” explains Lloyd, a former lifeguard. “Stacey went to alert the baristas that he might need help, and I began to mentally prepare myself for the possibility that I may need to perform CPR. That’s when I saw him stop breathing.”

Lloyd and Stacey immediately jumped into action. Lloyd cleared the surrounding furniture as Stacey checked for a pulse. Right as she found it, it disappeared. They moved Joe to the floor, and Stacey began to perform Hands-Only CPR. The barista Stacey had spoken to called 9-1-1.

Stacey and Lloyd performed Hands-Only CPR for almost 4 minutes until the paramedics arrived and took over. Once his pulse was restored, Joe was transported to a local hospital where he recovered.

“Speaking of the experience now seems surreal,” shares Lloyd. “I’m an Eagle Scout. It’s my mindset to be ready for anything, though I never expected something like this. I learned CPR growing up in Houston. My mom enrolled me in a city program for disadvantaged kids where I learned how to swim and eventually trained to be a lifeguard.”

“Not everyone needs to be an EMT, doctor, etc.,” added Stacey, who is studying to be an OBGYN. “But everyone should know the basics. One of the most alarming parts of this experience was, when Joe stopped breathing, everyone else in the cafe froze. I asked the barista if they had an AED, but he didn’t know how to respond. If Lloyd and I hadn’t been there, it’s likely no one would have been able to help.”

This is why Stacey, who is trained in BLS and ACLS, so strongly recommends the American Heart Association training—not just for medical professionals but for everyone.

“My training through the Association was great,” concludes Stacey. “What made it so effective is that it wasn’t just a lecture, but rather a hands-on experience. You don’t want to have to stop and think when seconds really count. I have no doubt that my training was critical to saving that man’s life.”

hidden Kurt’s Story

Kurt’s Story

Most people who experience cardiac arrest at home, work, or in a public location die because they don’t receive immediate CPR from someone on the scene. It’s important to remember that as a bystander, your actions can only help. When someone collapsed at his workplace, Kurt wasn’t afraid to step in and perform CPR until emergency help arrived.
hidden HeartCode PALS Demo Video

HeartCode PALS Demo Video

The American Heart Association’s HeartCode PALS Course, web-based and accessible 24 hours a day, provides a flexible, blended alternative to traditional classroom training. This online instructional program uses eSimulation technology to allow students to assess and treat pediatric patients in virtual healthcare settings. In this environment, students apply their knowledge to real-time decision-making and skills development. The goal of the PALS Course is to improve the quality of care provided to seriously ill or injured children, resulting in improved outcomes. After completing the online portion, students attend a hands-on session to test their skills with an AHA Instructor or on a voice-assisted manikin (VAM).