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.

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.

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.

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.

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

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.

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.

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.

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.

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.