‘What if I had known?’: A local nurse shares why everyone should learn CPR

June marked National CPR and AED Awareness Month, and with heart disease remaining the leading cause of death in the United States, a local nurse is urging the public to learn a skill she said could mean the difference between life and death.

Brenda Conch, director of the American Heart Association Training Center at United Hospital Center and director of the stroke program at UHC, has been teaching cardiopulmonary resuscitation to people of all ages since 1987. She said CPR performed in the first minutes after cardiac arrest can double or triple a person’s chances of survival.

What is CPR and why does it matter?

Cardiopulmonary resuscitation, or CPR, is a procedure that can be performed by anyone when an individual collapses from sudden cardiac arrest. It uses chest compressions to circulate oxygen-rich blood to the vital organs when the heart has stopped.

An AED, automated external defibrillator, can be used alongside CPR to deliver an electric shock to help restart the heart. Conch said AEDs are designed to detect shockable heart rhythms, such as ventricular fibrillation and ventricular tachycardia, which are among the most common causes of sudden cardiac events.

Conch said sudden cardiac arrest happens more frequently outside of the hospital than inside, making it critical for everyday people to know the basics.

“There would be nothing worse for me personally than to have somebody fall out in front of me and not know what to do and not be able to help or at least try to save my loved one or my neighbor or anybody for that matter,” Conch said. “I would always wonder, what if I had known how to do that? What if it made a difference?”

How to perform CPR

Conch said people should not hesitate to act out of fear of doing it wrong. She said finding hand placement is the easiest part of the procedure.

If you find someone unresponsive, not breathing, not moving, not responding to you, Conch recommends the following steps:

1. Call for help: Shout for assistance and call 911 immediately.
2. Check for responsiveness: Gently shake and shout at the person. If there is no response, no movement, and no normal breathing, or only occasional gasping breaths, begin CPR.
3. Find hand placement: Place the heel of your hand in the center of the chest, directly on the breastbone. Draw an imaginary line straight down from the chin to the belly button and across from the armpits, the center point is where your hands should go.
4. Lock your fingers: Bring your other hand over and lock your fingers together, keeping them off the chest.
5. Compress: Push straight down, about two inches in depth, at a rate of 100 to 120 compressions per minute, roughly the beat of the song Stayin’ Alive. Do not rock forward or backward. Push straight up and straight down, like a plunger.
6. Keep going: For untrained individuals performing CPR on adults, hands-only compressions are recommended. Continue until EMS arrives, an AED becomes available, or the person shows obvious signs of life.

Conch said that for infants, birth to about one year, the depth should be reduced to about three-quarters of an inch. For children around ages eight to ten, the recommended depth is about an inch and a half. The rate remains the same across all age groups.

For infants, children, and drowning victims, Conch said it is these circumstances when rescue breaths should be considered in addition to compressions.

What about injuring someone during CPR?

Conch said the risk of injury, including a broken rib, is far outweighed by the risk of not acting.

“Not doing CPR is a much higher risk to that individual, because they’re probably going to die,” Conch said. “A fractured rib is a small price to pay for continuing to live and come back home.”

What about breathing?

For untrained individuals performing CPR on adults, Conch said hands-only compressions are preferred. She explained that a person who has just collapsed still has oxygen-rich blood in their body, and chest compressions alone can circulate that blood effectively, at least for the first four to six minutes.

“We also know that they’re not using as much oxygen when their body is not moving,” Conch said. “So they’re using less oxygen, so they actually need less.”

Trained healthcare providers follow a 30-compression, two-breath cycle before returning to the chest.

The stakes of waiting

Conch said early CPR is a critical link in what she called the chain of survival for sudden cardiac arrest victims.

“If we don’t start early, then people don’t recover as well and they don’t get to return home to their loved ones,” Conch said. “They typically die in the first three or four days after that event.”

She said the public plays a vital role in that chain, one that hospital staff alone cannot fill.

“Sudden cardiac arrest happens more frequently outside in the community than it does in the hospital,” Conch said. “It can happen at any time to anybody.”