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The Importance of Knowing Hands Only CPR
Katherine Baca discusses the importance of knowing how to properly perform CPR as well as the up to date recommendations when it comes to learning and performing CPR.
Featured Speaker:
As the cardiac care coordinator, since April 2015, I am responsible for ensuring that the hospital is meeting best practice guidelines and standards for the ACS patient population. I lead the hospital’s accreditation from the Society of Cardiovascular Patient Care and designation as a STEMI receiving center from the San Diego County EMS Agency. This includes maintaining, presenting, and leading quality initiatives for the National Cardiac Data Registry. I have organized and presented multiple educational offerings to staff, EMS providers, and the general public in varying venues including health fairs, classroom, and the clinical setting. I participate in various multidisciplinary committees, respond to code STEMI activations, and research best practice to create policies/protocols in my commitment to provide the highest quality of care for our cardiac patient population.
Katherine Baca, RN
Katherine Baca, RN is Cardiac Care Coordinator, Temecula Valley Hospital Temecula, CA.As the cardiac care coordinator, since April 2015, I am responsible for ensuring that the hospital is meeting best practice guidelines and standards for the ACS patient population. I lead the hospital’s accreditation from the Society of Cardiovascular Patient Care and designation as a STEMI receiving center from the San Diego County EMS Agency. This includes maintaining, presenting, and leading quality initiatives for the National Cardiac Data Registry. I have organized and presented multiple educational offerings to staff, EMS providers, and the general public in varying venues including health fairs, classroom, and the clinical setting. I participate in various multidisciplinary committees, respond to code STEMI activations, and research best practice to create policies/protocols in my commitment to provide the highest quality of care for our cardiac patient population.
Transcription:
Welcome to TVH health chat with Temecula Valley hospital. I'm Prakash Chandran. And today we're discussing the importance of hands only CPR and how it can save someone's life. Joining me today is Katie Baca and she's a cardiac program manager at Temecula Valley hospital. Katie I'd like to start with the basics for our listeners.
Tell us what exactly is CPR.
Katherine Baca: Okay. So CPR, it stands for cardiopulmonary resuscitation. It is an intervention that a bystander can perform on someone who has lost their pulse or lost their heartbeats. And it is absolutely crucial in the chain of survival for patients.
Prakash Chandran: And can you go into a little bit more detail around what CPR does to the brain and the body when someone is performing it?
Katherine Baca: Sure. So performing CPR, you are pushing on the patient's chest in the area where the patient's heart is resting. And essentially, what you are doing is you are taking over the pumping of the heart for that patient. So by pumping the oxygenated blood in the patient's heart through their body, you are getting oxygen blood to the brain, and that is helping to keep the brain from essentially dying, from losing itself. And it is absolutely critical for these patients, even if they were to survive without CPR, a lot of them end up being brain dead because they didn't get oxygen for an extended period of time. So by compressing the patient's chest, you are pumping the heart for that patient and getting that oxygen-rich blood to the brain.
Prakash Chandran: One of the things that I've noticed is that whether it be a bystander or an emergency responder, CPR is the first thing that they go to try to resuscitate the person. So my question really is around when CPR should be used, is it always the first thing that you do when you come across an unconscious person?
Katherine Baca: Sure. So if you were to come across someone who was unconscious, laying on the ground or if you were with somebody and all of a sudden they collapsed, you want to go ahead and first call 911. And secondly, begin chest compressions. The American Heart Association has recommendations for hands-only CPR. And that means that you're only pushing on the patient's chest with your hands. You're not doing the rescue breathing. Especially in this COVID era, we don't want to be spreading communicable disease especially if you don't know the individual that's on the ground. But being able to stop and intervene and perform chest compressions would definitely help save that person's life.
Prakash Chandran: Absolutely. So hands-only is the recommendation, but can you talk a little bit about the rescue breathing component and when that should be used?
Katherine Baca: Yes. So in traditional CPR, there was a sequence of chest compressions to breathing for the patients. And the American Heart Association has gone away so that when it comes to a lay person performing CPR. We really want to encourage that chest compressions are being done for these patients. The science has shown that it's the chest compression that are going to provide the vital oxygen to the patient's brain tissue for saving the patient at the end of the day.
And if you're not comfortable or trained in performing the rescue breaths in sequence with chest compressions, we still want you to be able to feel comfortable trying to help another person who is in deep trouble. So the American Heart Association has given the recommendations of doing hands-only CPR for the bystander in an emergency situation. This can also be coached to you through a 911 operator as well should you forget. But the biggest thing is if you come across a person who's unconscious, they are not responding when you shake and shout, you dial 911, you put your hands in the center of their chest on their breastbone, between their nipples and just start pushing hard and fast to a hundred beats per minute.
Prakash Chandran: Okay. Yeah, I was just going to ask you about the explanation of how to do it. So you put your hands in between their breastbone, push down hard. And when you say hard, how hard are we talking?
Katherine Baca: We want to see a drop of at least two inches on the patient's chest. So you definitely want to feel a good compression with keeping your arms straight and locked, pushing into the patient's chest, pushing in at least two inches. And when you release in between pushes, you want to make sure the chest has a chance to fully recoil and open back up.
And the most important thing is just those good, hard compressions and making sure you're doing it to a hundred beats per minute.
Prakash Chandran: Okay. So that hundred beats per minute, what exactly is that like? For someone that doesn't necessarily know what that sound or what that cadence should be, is it something like one, two, three? Or is it faster than that?
Katherine Baca: It's definitely faster than that. So, the old standby has been that Bee Gees song, Staying Alive with like the metronome in the background, Staying Alive. But now, if you actually go on the American Heart Association, they have a Spotify playlist of current music that includes Beyonce, Gwen Stefani, Maroon Five, that all have the beat of a hundred beats per minute. And that I think is a little bit more relevant to younger generations that may not be familiar with the Staying Alive song.
Prakash Chandran: Okay. I am definitely familiar with the Staying Alive song. So I will have that song in my head should I ever come across someone that needs it. Okay. So I want to learn a little bit more about CPR certification. I remember when I was younger, I did Junior Lifeguards and it was a whole process around getting certified to do CPR. What is the rule of thumb around lay people just being proactive about getting certified?
Katherine Baca: So if you want to get certified just in case there is an emergency in your life, you can always go to heart.org/cpr and there's information there for classes. You just put in your ZIP code. It will tell you all of the local entities that can supply you with certification in CPR. I do recommend that. I mean, you'll learn a lot more specifics about CPR. You'll learn how to help with infant choking and CPR with child resuscitation in addition to adults resuscitation. So that is a great thing to be proactive about.
Prakash Chandran: Okay. And one of the things that I didn't ask you is, once you start doing those compressions at a hundred beats a minute, when do you know how to stop? Or how do you know if it's working? What signs should people be looking for?
Katherine Baca: Sure. So in the chain of survival, obviously, the first thing we've done is we've called 911 and we have started pushing hard and fast with CPR. If the patient begins to breathe, if they grab your arm, if they open their eyes, those are all signs that what you're doing is working as far as providing blood flow to the brain. Also, most of the time the EMS providers will arrive. You'll have paramedics, ambulance arrive in time to help assess that piece of the situation as well.
Prakash Chandran: Okay. And let's say you're able to resuscitate someone and they come back to consciousness, what is the next best thing that you should do? Should you just have them sit down or give them water? Maybe talk about that for a little bit.
Katherine Baca: Okay. If they were to regain consciousness, you want them to rest. You want them to rest, lay flat, lay on their side if they feel like they're going to vomit. And just wait for the EMS providers to get there, to do their full assessment of the patient. The most important thing is to not leave the patient alone.
There are instances where you, as the CPR provider, are providing the blood flow to the brain. And the second you stop, the patient may not be getting enough blood flow and they may again go unresponsive. So it is vital that you are present and just staying there until the emergency medical services arrives.
Prakash Chandran: Okay. And if you are trained in that rescue breathing, should you still do hands-only CPR given the environment we live in today?
Katherine Baca: Not specifically. This hasn't been stated from the AHA directly, but if you are trained in giving rescue breathing, the hope is that you would give the highest quality CPR that you are trained to perform.
Prakash Chandran: Okay. Makes sense. So, is there anything else that you think that the public needs to know around CPR, how it can save a life or the mechanism on how to do it?
Katherine Baca: So, the public just needs to know that CPR is so important for survival. Don't watch your loved one or someone collapse in front of you and do nothing. It really impacts the patient's life expectancy. For every minute that CPR is delayed, the patient's chance of surviving decreases by 10%.
And when you really look at that statistic, it's terrible. We want to make sure that we're doing this for our loved ones. We're doing this to help humanity. And it really is the difference, those first pivotal minutes is the difference in life or death for people. And it really is crucial for the public to know, call 911, start CPR and stay with the patient.
Prakash Chandran: Okay, Katie. Well, this has been hugely informative and I really appreciate your time today. You can also head over to our This email address is being protected from spambots. You need JavaScript enabled to view it. slash services, flash heart dash and dash vascular slash cardiology for more information, and to get connected with one of our providers that concludes this episode of TVH health chat with Temecula Valley hospital.
Please remember to subscribe, rate and review this podcast and all other Temecula Valley hospital podcasts physicians are independent practitioners who are not employees or agents of Temecula Valley hospital. And the hospital shall not be liable for actions or treatments provided by physicians to macula Valley hospital is directly or indirectly owned by a partnership that includes physician owners, including certain members of the hospital, medical staff.
I'm Prakash Chandran. And thanks for listening.
Welcome to TVH health chat with Temecula Valley hospital. I'm Prakash Chandran. And today we're discussing the importance of hands only CPR and how it can save someone's life. Joining me today is Katie Baca and she's a cardiac program manager at Temecula Valley hospital. Katie I'd like to start with the basics for our listeners.
Tell us what exactly is CPR.
Katherine Baca: Okay. So CPR, it stands for cardiopulmonary resuscitation. It is an intervention that a bystander can perform on someone who has lost their pulse or lost their heartbeats. And it is absolutely crucial in the chain of survival for patients.
Prakash Chandran: And can you go into a little bit more detail around what CPR does to the brain and the body when someone is performing it?
Katherine Baca: Sure. So performing CPR, you are pushing on the patient's chest in the area where the patient's heart is resting. And essentially, what you are doing is you are taking over the pumping of the heart for that patient. So by pumping the oxygenated blood in the patient's heart through their body, you are getting oxygen blood to the brain, and that is helping to keep the brain from essentially dying, from losing itself. And it is absolutely critical for these patients, even if they were to survive without CPR, a lot of them end up being brain dead because they didn't get oxygen for an extended period of time. So by compressing the patient's chest, you are pumping the heart for that patient and getting that oxygen-rich blood to the brain.
Prakash Chandran: One of the things that I've noticed is that whether it be a bystander or an emergency responder, CPR is the first thing that they go to try to resuscitate the person. So my question really is around when CPR should be used, is it always the first thing that you do when you come across an unconscious person?
Katherine Baca: Sure. So if you were to come across someone who was unconscious, laying on the ground or if you were with somebody and all of a sudden they collapsed, you want to go ahead and first call 911. And secondly, begin chest compressions. The American Heart Association has recommendations for hands-only CPR. And that means that you're only pushing on the patient's chest with your hands. You're not doing the rescue breathing. Especially in this COVID era, we don't want to be spreading communicable disease especially if you don't know the individual that's on the ground. But being able to stop and intervene and perform chest compressions would definitely help save that person's life.
Prakash Chandran: Absolutely. So hands-only is the recommendation, but can you talk a little bit about the rescue breathing component and when that should be used?
Katherine Baca: Yes. So in traditional CPR, there was a sequence of chest compressions to breathing for the patients. And the American Heart Association has gone away so that when it comes to a lay person performing CPR. We really want to encourage that chest compressions are being done for these patients. The science has shown that it's the chest compression that are going to provide the vital oxygen to the patient's brain tissue for saving the patient at the end of the day.
And if you're not comfortable or trained in performing the rescue breaths in sequence with chest compressions, we still want you to be able to feel comfortable trying to help another person who is in deep trouble. So the American Heart Association has given the recommendations of doing hands-only CPR for the bystander in an emergency situation. This can also be coached to you through a 911 operator as well should you forget. But the biggest thing is if you come across a person who's unconscious, they are not responding when you shake and shout, you dial 911, you put your hands in the center of their chest on their breastbone, between their nipples and just start pushing hard and fast to a hundred beats per minute.
Prakash Chandran: Okay. Yeah, I was just going to ask you about the explanation of how to do it. So you put your hands in between their breastbone, push down hard. And when you say hard, how hard are we talking?
Katherine Baca: We want to see a drop of at least two inches on the patient's chest. So you definitely want to feel a good compression with keeping your arms straight and locked, pushing into the patient's chest, pushing in at least two inches. And when you release in between pushes, you want to make sure the chest has a chance to fully recoil and open back up.
And the most important thing is just those good, hard compressions and making sure you're doing it to a hundred beats per minute.
Prakash Chandran: Okay. So that hundred beats per minute, what exactly is that like? For someone that doesn't necessarily know what that sound or what that cadence should be, is it something like one, two, three? Or is it faster than that?
Katherine Baca: It's definitely faster than that. So, the old standby has been that Bee Gees song, Staying Alive with like the metronome in the background, Staying Alive. But now, if you actually go on the American Heart Association, they have a Spotify playlist of current music that includes Beyonce, Gwen Stefani, Maroon Five, that all have the beat of a hundred beats per minute. And that I think is a little bit more relevant to younger generations that may not be familiar with the Staying Alive song.
Prakash Chandran: Okay. I am definitely familiar with the Staying Alive song. So I will have that song in my head should I ever come across someone that needs it. Okay. So I want to learn a little bit more about CPR certification. I remember when I was younger, I did Junior Lifeguards and it was a whole process around getting certified to do CPR. What is the rule of thumb around lay people just being proactive about getting certified?
Katherine Baca: So if you want to get certified just in case there is an emergency in your life, you can always go to heart.org/cpr and there's information there for classes. You just put in your ZIP code. It will tell you all of the local entities that can supply you with certification in CPR. I do recommend that. I mean, you'll learn a lot more specifics about CPR. You'll learn how to help with infant choking and CPR with child resuscitation in addition to adults resuscitation. So that is a great thing to be proactive about.
Prakash Chandran: Okay. And one of the things that I didn't ask you is, once you start doing those compressions at a hundred beats a minute, when do you know how to stop? Or how do you know if it's working? What signs should people be looking for?
Katherine Baca: Sure. So in the chain of survival, obviously, the first thing we've done is we've called 911 and we have started pushing hard and fast with CPR. If the patient begins to breathe, if they grab your arm, if they open their eyes, those are all signs that what you're doing is working as far as providing blood flow to the brain. Also, most of the time the EMS providers will arrive. You'll have paramedics, ambulance arrive in time to help assess that piece of the situation as well.
Prakash Chandran: Okay. And let's say you're able to resuscitate someone and they come back to consciousness, what is the next best thing that you should do? Should you just have them sit down or give them water? Maybe talk about that for a little bit.
Katherine Baca: Okay. If they were to regain consciousness, you want them to rest. You want them to rest, lay flat, lay on their side if they feel like they're going to vomit. And just wait for the EMS providers to get there, to do their full assessment of the patient. The most important thing is to not leave the patient alone.
There are instances where you, as the CPR provider, are providing the blood flow to the brain. And the second you stop, the patient may not be getting enough blood flow and they may again go unresponsive. So it is vital that you are present and just staying there until the emergency medical services arrives.
Prakash Chandran: Okay. And if you are trained in that rescue breathing, should you still do hands-only CPR given the environment we live in today?
Katherine Baca: Not specifically. This hasn't been stated from the AHA directly, but if you are trained in giving rescue breathing, the hope is that you would give the highest quality CPR that you are trained to perform.
Prakash Chandran: Okay. Makes sense. So, is there anything else that you think that the public needs to know around CPR, how it can save a life or the mechanism on how to do it?
Katherine Baca: So, the public just needs to know that CPR is so important for survival. Don't watch your loved one or someone collapse in front of you and do nothing. It really impacts the patient's life expectancy. For every minute that CPR is delayed, the patient's chance of surviving decreases by 10%.
And when you really look at that statistic, it's terrible. We want to make sure that we're doing this for our loved ones. We're doing this to help humanity. And it really is the difference, those first pivotal minutes is the difference in life or death for people. And it really is crucial for the public to know, call 911, start CPR and stay with the patient.
Prakash Chandran: Okay, Katie. Well, this has been hugely informative and I really appreciate your time today. You can also head over to our This email address is being protected from spambots. You need JavaScript enabled to view it. slash services, flash heart dash and dash vascular slash cardiology for more information, and to get connected with one of our providers that concludes this episode of TVH health chat with Temecula Valley hospital.
Please remember to subscribe, rate and review this podcast and all other Temecula Valley hospital podcasts physicians are independent practitioners who are not employees or agents of Temecula Valley hospital. And the hospital shall not be liable for actions or treatments provided by physicians to macula Valley hospital is directly or indirectly owned by a partnership that includes physician owners, including certain members of the hospital, medical staff.
I'm Prakash Chandran. And thanks for listening.