Eps. 13 | Step In, Save a Life: What to Do During Cardiac Arrest

When every second counts, knowing what to do can save a life.
In this episode of Step In, Save a Life: What to Do During Cardiac Arrest, we’re joined by clinical educator Pat Billings to walk through exactly how bystanders can step in with confidence. From recognizing cardiac arrest to performing hands-only CPR and using an AED, this conversation breaks down the fear and replaces it with action.
You do not need to be a medical professional to make a difference. You just need to be ready.
▶ Learn the signs
▶ Take action quickly and with confidence
▶ Be the reason someone gets a second chance
Because in an emergency, doing something is always better than doing nothing

Want more heart health information? 
Visit wewnetwork.org/heart-health-aed
-or- 
heart.org

The EmpowerND Podcast is hosted by Women Empowering Women, a membership based non-profit organization dedicated to connecting, supporting, and educating women. Through community, events, and resources, Women Empowering Women helps women grow, build confidence, and explore their potential, supporting them every step of the way as they become the best version of themselves. To learn more about Women Empowering Women’s projects or how to become a member, visit wewnetwork.org.

Transcript

SPEAKER_01 0:11

The Empower Indy podcast is produced by Women Empowering Women, a nonprofit organization dedicated to connecting, supporting, and educating women to help them become the best versions of themselves. To become a member or learn more, visit WEW Network.org. What would you do if someone collapsed right in front of you? In those first few moments, what you do or don't do can mean the difference between life and death. Today, we're breaking down what actually happens during cardiac arrest, what bystanders should do, and how CPR and using an AED can save a life. Can you just introduce yourself?

SPEAKER_00 0:57

My name's Pat Billings, and I am the clinical educator at CHI St. Alexis Health here in Dickinson. And I've been a nurse for many years.

SPEAKER_01 1:07

And what do you help with clinical education? Like what do you what do you teach?

SPEAKER_00 1:11

Oh, I um orient new nurses, new CNAs, I teach different classes, I organize biannual skills fairs to keep everybody competent.

SPEAKER_01 1:22

Um and you do some community outreach as well.

SPEAKER_00 1:24

Yeah, I love to do that too.

SPEAKER_01 1:26

Okay. So when a bystander encounters a sudden collapse, what are the immediate priorities in those first few moments?

SPEAKER_00 1:34

So if somebody were to collapse suddenly, they need to recognize it. So that's one of the key things, kind of recognizing the emergency. So if somebody collapses, you want to kind of shake them, try to wake them up. If they don't move, don't blink, you know, are not doing anything like that, and you don't observe any normal breathing, sometimes in those, especially if it's initial, they could be gasping, there could be some movement, there could even be a little bit of like seizure activity, but it doesn't last. And so those kinds of things you want to call 911 right away.

SPEAKER_01 2:07

Okay, so from a clinical perspective, what's happening um with the actual heart tissue when a heart attack happens?

SPEAKER_00 2:15

So it's a change in the rhythm. Um, the electrical activity of the heart alters the rhythm and the heart's not pumping anymore. And that's what gets the blood to the brain and to the rest of the organs. So when that's not happening, then somebody else needs to step in and pump that blood for the heart.

SPEAKER_01 2:29

Okay. How quickly does irreversible damage begin without intervention?

SPEAKER_00 2:33

Within minutes, just a few minutes. They say maybe every minute you could be decreasing the chance of by 10%, even so survival.

SPEAKER_01 2:41

So hesitation is common in these situations. What do you want people to move past in that moment?

SPEAKER_00 2:47

So I know there's some factors, different things, especially if there's a few people there. Then when you have a group of bystanders, sometimes everybody's like, oh, they're gonna do it, somebody else is gonna do it. No, you need to just step up and just try to arouse the person, just like I described. Call 911, even if you don't know for sure what it is, get help coming, get that EMS arriving. People are worried about legal ramifications, and we have the Good Samaritan law. So you're protected if you try to help somebody. Um, and then there's other things with, you know, oh, I might hurt them. Well, they're dead. So when you break a few ribs doing compressions, it's okay. Those will heal. Um, so those kinds of things, kind of.

SPEAKER_01 3:27

How has CPR guidance evolved, um, particularly with the shift towards hands-only CPR?

SPEAKER_00 3:33

Well, they've really realized, um, especially with what we call out-of-hospital cardiac arrests, that we need the bystander piece. We need people to step up and start that process, recognize it, call 911, and start compressions. And they were finding barriers, especially with the breaths, um, if they weren't properly trained. And people were hesitant. Who wants to give somebody mouth to mouth when you don't know them? So, um, so they went to the hands-only CPR. So, and you can even do that through clothes. You don't have to take shirts off or anything, just start compressions right away, call 911, and then um, yeah, and then you go from there.

SPEAKER_01 4:09

Okay, can you define the chain of survival and explain how each step connects, uh, including where the bystander plays a role in those first critical moments?

SPEAKER_00 4:17

Yeah, yeah. So they've added a step. Um, I don't know if it's been maybe in the last four years or so, but the first step is recognition and activation. So they're gonna you got to recognize that person's in an emergency and call 911. And our dispatch here, which is wonderful, are all trained in TCPR, telephone CPR. So they can coach you through it. They want to help you with that. So you start, that's recognition and then compression, so high quality CPR. And then it's the defibrillator, which we haven't talked about yet, or the AED. That's what's gonna give the heart that electricity to help it get back in its normal rhythm. And then you have the EMS arriving, and they have better, they have medications and things that they'll add. And then it's um the hospital care and um recovery. Recovery they found is a very important piece too.

SPEAKER_01 5:07

So, in a high stress situation, what's the simplest way to maintain the proper rhythm?

SPEAKER_00 5:14

Well, that staying alive song is the popular one, but there are many other songs. So if people aren't like baby sharks, there's some other ones, and you can go to the American Heart Association's website and look up ones that have that same rhythm. So maybe there's some other song that's more of a favorite for you, and you can find out what that is and use that.

SPEAKER_01 5:32

And then just kind of walk us through uh effective compression technique, including like where the hands are placed, and then depth and pace.

SPEAKER_00 5:40

They say put the hand, your hands in the center of the chest, or I would say the heels of your hands kind of go together on the breastbone, the center of the chest, and like right between the breasts, right between the nibbles there. Um, start pressing there. You want to lock your elbows, be straight over um the person's chest so that you're pressing down with your whole body. You're not using just your arms because you'll tire out too fast. And you want to go, I mean, for us ladies, probably kind of as deep as you can go. Um, so they say two inches depth, but it's hard to adjust what that is in a real life situation. But you want to go, yep, deep enough to pump that blood. You want to make sure the chest comes all the way back up because just picture it, you're kind of squishing that heart in between the breast above the chest and the back. And every time you let the heart, if you bring your hands all the way back up, let the chest, what they call recoil, come all the way back up, the heart's filling up with blood again completely, and then you're pumping again. But if you only go up part way, then you're only filling the heart with about half amount of blood. So you're not being as effective.

unknown 6:44

Okay.

SPEAKER_00 6:44

So this is how you would do hands-only CPR. First, you have to have the um person on a firm, flat surface. So if they're on a bed, you want to put them, pull them down onto the floor. And then you want to, like I said, you don't have to take off their clothes, but you want to put your hands in the center of their chest, so kind of like right the heel of the hand, right on the sternum of the breastbone, right between the breasts. And then you want to lock your hands on top and you lock your elbows so you're straight over them, and then you press down hard and fast, just like that. And then you just keep going. And 911 will coach you through and you can count out loud and they'll help you with your rate. And if you have somebody else there with you, you can trade off until the ambulance arrives.

SPEAKER_01 7:28

And you mentioned AEDs, so they're becoming more right widely available, but still kind of intimidating for people. So, should a bystander use one without hesitation?

SPEAKER_00 7:39

Yes, they should. They've kind of made them for the bystander. That's what they're out there for. Um, they're called the automated external defibrillator. And you basically just do I'm I describing how they do it now or yeah. Oh, okay. So um, so they would you basically you want to turn it on. That's the main thing. Some of them, when you open them up, um, they automatically turn on. Others you have to push the button. So that's the first step. Turn on the AED and then it walks you through the steps. It's gonna tell you to, you know, see if they're arousable or not. It's gonna tell you the steps to call 9112. It's gonna remind you to do that. Um, and it's gonna have you put the pads on. That's when you're gonna have to take the shirt off. Now they're even saying now, you as long as you can put the pads on the skin in the in the pictures on the pads show you where to put them. If you can put them on the skin, you don't even have to take off all the clothes. So if you're if it's a woman and you're afraid to take off their bra, you can put it under the bra and around. So um, but I say if you're dead, I mean I don't care if you take off my bra.

SPEAKER_01 8:38

Yeah. I think that's um important for people to know too that it's not it's not an embarrassment thing at that point. It's life or death. Yes. So you have to get that out of your mind that that they're going to be embarrassed. Right. They're going to be grateful.

SPEAKER_00 8:53

Right. And there is research that shows that that is an issue because, you know, men tend to receive CPR more often than women do. And so they were like, what the heck? Why is this happening? And they thought, you know, part of it is, you know, they don't want to take off the clothes. They don't, and a lot of times it's men that are responding and they don't want to put their hands on the woman's chest. So they've now started making more um uh, you know, female mannequins because they did a disservice to us ladies by always having anatomical male mannequins. So now they have breasts you can attach to mannequins and/or mannequins that have breasts too, so that they're trying to overcome that hurdle.

SPEAKER_01 9:30

Okay. Uh, what does the data show about survival when bystanders intervene with CPR and an AED?

SPEAKER_00 9:38

Well, they say that um you can double or triple the chance of a person's survival from having somebody start CPR right away and getting that um calling 911, getting that AED.

SPEAKER_01 9:48

So, for someone listening, what are the key actions you want them to remember and carry into a real emergency?

SPEAKER_00 9:54

Take a deep breath. Because you're always gonna panic. Even if you took a class or you know, you learned you know how to do CPR, you're gonna panic. So, but you know, checking the patient, the person, you know, are they okay or not? Calling 911, they'll calm you down, they'll coach you through it. So even if you're like, oh, I totally forgot what I need to do, that's okay. They'll help you. And um, and then it's just getting those compressions started right away. And then if there is an AED in the area, you know, sending somebody to get it. We don't want to stop compressions once we start them. We want to keep going. And yeah, so and yeah, that. And then just don't be afraid, you know, just step up and be willing. And then they say too that, you know, 70% of the out-of-hospital cardiac arrests happen in home. So it's your loved one. So think about that. And you can always to kind of refresh yourself, you can go back to the American Heart Association and watch one of their hands-only CPR videos as a refresher, as a reminder of what you're doing and stuff too.

SPEAKER_01 10:51

So, in those first moments, you are the difference. Trust yourself, act quickly, and remember doing something is always better than doing nothing. Thanks for listening. Thank you, Pat, for being here today. And thank you to our listeners for joining us. Until next time, stay informed, stay empowered, and we'll see you on the next Empower Indie Podcast.