Cardiac Emergencies: Are You Prepared with the Right CPR Skills?

In today's episode, we dive deep into the crucial distinctions between heart attacks and cardiac arrests with our esteemed guest, Joel Holley. Joel, an experienced occupational therapist, assistant, and CPR instructor, brings his wisdom and practical knowledge to the conversation.

 We'll explore the life-saving techniques of hands-only CPR, proper hand placement, and the importance of compression depth. Joel's insights highlight why effective CPR training is vital, including the adrenaline rush that helps individuals perform under pressure, and his real-world experience that underscores the gravity of these moments.

 This episode is packed with essential information for everyone, from caregivers to the general public. Joel also shares invaluable advice, including his father’s mantra: "plan for the worst, hope for the best." Whether you are CPR certified or not, this episode promises to equip you with knowledge that could one day save a life. So, stay tuned and be prepared to make a difference!

Visit: https://www.Holleysafteygroup.com

 SeniorLivingGuide.com Podcast sponsored by TransMed Care Long Distance Medical Transportation

 The background music is written, performed and produced exclusively by purple-planet.com.

https://www.purple-planet.com/

 *SeniorLivingGuide.com Webinars and Podcast represents the opinions and expertise of our guests. The content here is for informational and educational purposes. It does not necessarily represent the views, recommendations, opinions or advice of Fairfax Publishing/SeniorLivingGuide.com or its employees

Transcript

Darleen Mahoney [00:00:02]:

And today we are joined by Joel Holley. He is a current occupational therapist, assistant and CPR instructor and has been in the healthcare industry since 2015. He has devoted his life to helping local communities by educating others or on simple safety measures that can be used in and out of the home. As the owner of Holly Safety Group, with locations in Florida and in South Carolina, their mission is to empower people to be their own lifesavers. Welcome to seniorlivingguide.com podcast.

Joel Holley [00:00:36]:

Good to be here. Good to be here. Thank you so much for the opportunity.

Darleen Mahoney [00:00:40]:

Yeah, absolutely. Thank you for joining me today. And I know that one of the things that you do at Holly Safety Group is train people on saving lives through CPR.

Joel Holley [00:00:52]:

Absolutely. Yes. One of the most important things that we try and emphasize is throughout the entire class, it may be, you know, 3 hours long, but there are certain aspects of it that no matter how long it's been, this is a skill that we want to teach you, if nothing else. And that comes down to the compressions. So I always tell my students, when we're going over how to do CPR, we go over scene safety. You can't help anybody if you have the potential of becoming a patient yourself. Once you know that the scene is safe, you're going to your potential patient. If there are people there, you start designating, you call 911, you go find the AED, the automated external defibrillator.

Joel Holley [00:01:44]:

You play eye of the tiger, and everybody always looks at me. We'll get to that. So basically what that is, is the ratio of how fast you're pumping is 100 to 120 beats per minute. In a classroom, that's easy to remember, but when it's emergency mode, that adrenaline is going. You're not going to remember that. But you can remember a song that's in between there. Eye of the tiger, dock of the bay, baby shark, another one bites the dust. And I always say, I don't recommend singing that one out loud, but it is an option.

Joel Holley [00:02:21]:

So I always give people the homework of find a song between 100 and 120 beats per minute. That's a song that you can, no matter what you can remember. So you get that rhythm down. Because CPR is three components of importance. The depth in which you push one third the depth. And that's for everybody from a baby to Shaq. They can be built like the rock or Taylor Swift. Everybody's body type is different, but that depth range is the same.

Darleen Mahoney [00:02:55]:

Okay.

Joel Holley [00:02:56]:

The ratio of speed, like I said before, the one to 120. And then how often you pump 30 compressions followed by two breaths. There are some exceptions when it comes to children and infants, but when in doubt, is that 30 compressions followed by two breaths?

Darleen Mahoney [00:03:16]:

Okay, so, first of all, how do you know if someone needs CPR? So you're in a room and something's happening. What are the clues? That that's 911 for sure. Colleen. But then also, what would make you think I need to give this person CPR versus doing nothing or whatever?

Joel Holley [00:03:37]:

Checking the heartbeat, checking the breathing. So when we check for adults for the pulse, you check the carotid artery. So if you go from the middle of your neck, where you can fill your throat, you go down to the ridge of your neck, you'll find the carotid artery, and all you're feeling for is that loved up that pressure.

Darleen Mahoney [00:04:00]:

Okay.

Joel Holley [00:04:01]:

If you're not feeling that, that's one sign that the heart is not pumping for the breathing. It's normal breathing, what we all do on a daily basis, that type of simple in and out breathing. When you see a patient gasping, it's not real breathing. I always give the example of, think about somebody who is asthmatic, or they're having anaphylaxis from whatever allergy or something they have. They're gasping for air. That's the body trying to fight to get air. Nobody walks around gasping like, hey, what you gonna do after this? And that. So if you don't see that normal breathing and there's no pulse, you start CPR.

Darleen Mahoney [00:04:53]:

Okay.

Joel Holley [00:04:55]:

There are other things that can be done for infants. We don't check their neck. We check the bend of their arm. And as far as the breathing, we still do that. We tickle the bottom of their foot. It's called an infant response, similar to when you put something next to a baby's lip. They go towards that for suckling. It's not something they're taught to.

Joel Holley [00:05:22]:

It's just a reaction. So it's the same thing with the toes. Even if they're not ticklish, they'll have some sort of movement on the toes. So that's how we check for the responsiveness. As always say, pulse, breathing, responsiveness.

Darleen Mahoney [00:05:35]:

Okay. And it's interesting that you mentioned the song that goes with the compressions. And I know, I think you and I talked about this because the office has a famous episode that highlights that. So in all honesty, I think that's really great, because that one episode really brought to life, even though it was done in a comedic format, how to properly do CPR in a snippet of a few minutes. But I thought that was really interesting, and I think they got a lot of positive feedback that they actually did have that on there.

Joel Holley [00:06:14]:

Several shows have done that. I think always sunny has done that. I know the Simpsons has, and it's memorable things.

Darleen Mahoney [00:06:22]:

Right, right. So quick question. So do you have any stories or real life experiences where you had someone that needed that CPR and someone that you've either worked with or trained or what have you has been able to perform that and it's made a life changing experience for someone?

Joel Holley [00:06:43]:

Yes. I was actually at a, like, a local bar and grill, and they had live music, and I was talking to somebody because one of the performers was playing the saxophone, and the person I was talking to knew the saxophone. So he's like, yeah, you should really go talk to him. He's a nice guy. And as I go over there, I kind of, like, tap his shoulder. He's slumped over and he's unresponsive. It just so happened that one of the bandmates, his girlfriend, now wife, was a nurse, so she and I took turns doing compressions breathing until the ambulance arrived. Turned out his cardiac arrest was due to drug overdose.

Joel Holley [00:07:29]:

He survived another year, but again, with poor choices. There's only so much that can be done. But we were able to save him at that point in time.

Darleen Mahoney [00:07:40]:

Yeah, there's only so much sometimes your body can take.

Joel Holley [00:07:43]:

Absolutely.

Darleen Mahoney [00:07:44]:

Yeah. Before it says, like, I can't do it anymore. So what is. Is there any difference between performing CPR on an older person? I know that you mentioned an infant, but a frailer, older person. Would you be more careful on your compressions, or do you take any of that into consideration?

Joel Holley [00:08:08]:

There's always some sort of mindset of, I got to be careful because a patient is fragile, but if you have that mindset and you hold back too much, you're not doing effective CPR. They will heal. The point is to get this done so that they survive, and we'll worry about the healing later on. I tell students often for infants and kids, when we do compressions, we are cracking their ribs, we are breaking the sternum. It's going to take about four to six weeks for them to heal. For adults, it's going to be triple that because it usually is a heart issue with adults, for children and infants is a breathing issue or a non breathing issue. As an occupational therapist, as well, after you go through CPR as an adult, you will be going through cardiac rehabilitation. But the point is, we got to get you to that point where you are alive to do so, to do the recovery.

Joel Holley [00:09:17]:

So I wouldn't necessarily hold back on the fear of that. It's going to be a process of rehabilitation regardless.

Darleen Mahoney [00:09:26]:

Okay. Are heart attacks one of the number one reasons people would receive CPR?

Joel Holleey [00:09:32]:

A heart attack and cardiac arrest are two different things. If you think about the description itself, an attack is something physical. It's happening, it's going arrest is when something is stopped. So a heart attack leads to cardiac arrest, but they're not the same thing. You would not do CPR on somebody having a heart attack because their heart is still pumping. You would definitely call 911, be monitored. It could be a myriad of things outside of the CPR realm, but you have 911 and having crystal clear description of what's going on gives them a better idea, gives the paramedics a better idea, and they have the medication that may stop it may be their heart is just fluttering so fast. Their heart is pumping super fast.

Joel Holley [00:10:19]:

It's going 200 plus miles per hour, pretty much. Paramedics are going to come in, they're going to give them a medication that'll actually slow down their heart rate before it starts to seize, before it starts to go into that cardiac arrest. So the 911 is still important. You just need to consider that's not the CPR point yet.

Darleen Mahoney [00:10:41]:

Okay. I did not know the difference between that. So you have educated me today on the difference. So, and hopefully some of our listeners as well. So when you use hand CPR, what's the difference between that and if an ambulance comes in and uses another form, the hand CPR, is that equally as effective or is it just getting there? What does that look like?

Joel Holley [00:11:10]:

So hands only CPR versus CPR in itself simply means all you're doing is compressions. You don't have anything that can act as a barrier between your mouth and the patient's mouth. You don't have an AED on site, so all you're doing is pumping. So we know that breathing oxygen is important. When we go down, we still have residual oxygen. When we go through our daily breathing regimente, we're not breathing out all the oxygen we have. We're not breathing in all we can. You have to force yourself to completely deplete yourself of air.

Joel Holley [00:11:53]:

So when you are in cardiac arrest, you still have residual oxygen. So just pumping that getting what oxygen is in your body, around the organs, the brain is going to take its line share to keep so that it survives and you just keep doing that. That ratio of 30 compressions and two breaths is no longer there. It's pump hard, pump fast. It's not even a matter of the speed at this point. Pump hard, pump fast, pump deep. There have been many, many cases where there has been no oxygen. Their patient may have been choking.

Joel Holley [00:12:29]:

Again, no barrier. A ton of different things to why they couldn't do the breathing. 15 minutes and. And longer paramedics arrive. They have oxygen. They have a way to get the object out. They start breathing again, they start giving them oxygen, and they recovered. They survived.

Joel Holley [00:12:49]:

So, yeah, it's just a matter of if you don't have all the tools available to you, a way to safely do breathing. Aed for defibrillation, all you have is your hands. You're going to use your hands, hands only.

Darleen Mahoney [00:13:02]:

Okay, so where exactly do your hands go on the person to make sure you're hitting the right spot?

Joel Holley [00:13:09]:

So everybody has pectoral muscles. If you take your hands into a fist and touch on the top of their chest, where you can feel the muscle develop, once you start going down to the point your knuckles touch, that's where you want your hands. It's somewhere around the nipple line, but nipple lines may vary, but that pectoral muscle range, you will eventually touch your knuckles together. That's where you want to place. You don't want to go too high up to the collarbone. You don't want to go too far down. There's a little arrowhead shaped bone called the xiphoid process. We don't want to go that far either.

Joel Holley [00:13:46]:

So if you do, the muscle connect is what I call it. That's where you want to place your hands.

Darleen Mahoney [00:13:52]:

Okay, well, that makes sense. So I know one of the things that you do is you provide classes for. Is it just anyone that wants to take a class?

Joel Holley [00:14:02]:

Yes, we provide classes for anybody who wants to take classes. Or if, like facilities, if they want group training, will go there, because at that point, we can kind of point out, hey, do you guys know where your AED is? And maybe something they pass every day and never thought about it. You play the way you practice. So if you're practicing in facility, you have a better idea of where to go, what to do, where your resources are, how to guide paramedics through in the class. We do the same thing, give them a little bit of a homework assignment, and hopefully they do it after they walk out.

Darleen Mahoney [00:14:39]:

Yeah. So what do you think the difference is for people that wing it as far as they're not taking a class, and maybe they've, like, read about it or they've heard about it, on where to properly perform on the body CPR versus someone that takes the time, goes to the class, gets certified. So what is the difference between someone that's just winging it and someone that really gets serious about it and takes the time to spend a few hours on a Saturday to go get that certification?

Joel Holley [00:15:11]:

Like I said before, you play how you practice, you could sit there with a pillow and a squeeze ball, put it underneath, and you think that you've got it. That pillow's a soft surface until you actually feel what one third the depth is. You're surprised how many students come in. We'll talk about it. Yeah, I've taken this class. This is a renewal. This is like 4th, 5th time I've done this. And then I go, okay, before we even work on speed, let's get that depth going.

Joel Holley [00:15:40]:

And I'll see them like, you're not doing anything. What do you mean, push down? And then they finally get that their eyes open. Like, I didn't realize it was that deep. It's that that realization of, you are going to have to go hard. I joke around, I go, you're not strong enough to get to the spine. There's too many giblets in there. But we got to get to the heart. We're going against our own body's design.

Joel Holley [00:16:09]:

Our ribs are made to protect. So now we're going to have to push beyond that. And that's what of the biggest things is speed. People go really, really fast. It's not something they're going to maintain. They'll eventually slow down. We can kind of get that going with, like you said, oh, I remember that episode of the office, or I remember somebody saying, staying alive, that's something that kind of, in our pop culture we can remember. But that depth is the important.

Joel Holley [00:16:39]:

If we don't have that depth and then what's called recoil, letting the chest come back up, if we don't get that right, we're not doing effective CPR. If you take a bicycle horn and you just squeeze, squeeze, squeeze, squeeze, squeeze without releasing, there's no air coming in, there's no sound coming out. It's the same thing with the heart. If you just push, push, push, push, push, and you're not letting the heart come back up to refill, you're not doing anything. So it's that technique that makes it very, very important.

Darleen Mahoney [00:17:07]:

That is the best description that I've heard ever about the heart and being able to recoil with CPR.

Joel Holley [00:17:16]:

Oh, I have a bunch of southern analogies.

Darleen Mahoney [00:17:23]:

Well, one of the things that you mentioned as well is if you really think about it, the depth, you have to get that depth in there in order to actually reach the heart, because you do have all this protection from the heart intentionally. For a healthy, well beating heart, that it does make it a little bit difficult to manually get down there and put some pressure on it to pump it.

Joel Holley [00:17:49]:

Don't be afraid of hurting them. It's that nothing in CPR is gentle. I've had some students, like, kind of get teary eyed, like, but I don't want to hurt them. But you want them to live. Those ribs will heal the AED. If you shock them, they will heal for the AED. I tell people, if you have an extremely hairy patient and there's no razor or scissors to open up, you have to rip that hair out. And I'll either get chuckles or Winston's like, come on, guys, think about it.

Joel Holley [00:18:20]:

We've been doing this for about two minutes where we've been pushing on the chest, in the ribs. We've cracked them, we've bruised them. If after that point, you grab the hair and start pulling, and that's when they start going Ouchenhein, they deserve an Oscar for being alive. That is committing to a role like I've never seen. Everything we do is kind of in the extreme because of the way our body is built. Don't worry. They will heal if they're alive. And that is our job, to make sure that they survive.

Joel Holley [00:18:50]:

For every minute. Without proper CPR, their chances go down 10%. So we got to get on it. We can't worry about that right now. Afterwards, when the paramedics are riding off with them, that adrenaline starts coming down. You're gonna get the shakes. It's cool, but you know that you did your best. Don't hold back for fear of hurting them.

Joel Holley [00:19:11]:

Give it your all for fear of losing them.

Darleen Mahoney [00:19:15]:

Yeah, yeah. So when do you real. When do you know that your CPR was effective and you need to stop doing the CPR?

Joel Holley [00:19:24]:

When the paramedics arrive and take them away.

Darleen Mahoney [00:19:32]:

So you just never. You never assume someone has recovered and they're. They're okay and good to go until.

Joel Holley [00:19:38]:

They start breathing, you feel a pulse, and they're responding. At that point, you put them on their left hand side. That's the recovery position. If there's an AED on them, you keep it on, keep it plugged in, placed on that heart just came back. So it is very, very weak. We don't want to assume that when they recover, everything is now right with the world. They are still on high alert. They're still being monitored, so you put them on their left side, keep 911 with you, talk to them a bit, keep that AED.

Joel Holly [00:20:16]:

If they go back out, you restart. But, um, quitting there, there is no stop, so to speak. So that's kind of how I answered the question before. It's a monitoring. At this point, it's no longer CPR, as in the compressions breathing. It is now CPR, monitoring the after effect, because they still need more help. There's something caused their heart to go into cardiac arrest, and us doing compressions and breathing on their own is not going to fix it. It's a temporary, it's a band aid on the top of a water hose until the paramedics arrive.

Joel Holly [00:20:54]:

Then it's the next step. When they get to the hospital, they have even more equipment to help them. It's the next step. So it's really no quitting, just monitoring from action or action to monitoring.

Darleen Mahoney [00:21:06]:

Okay. How long can someone typically do CPR before maybe someone else needs to, to step in? If you are waiting for an ambulance to arrive, you've called 911 and they're not getting there as fast as what you can physically do CPR.

Joel Holly [00:21:22]:

There are people that have gone 1520 minutes longer and slept the rest of the day. With the good Samaritan law, one of the reasons why training is so important is because once you get that certification, you fall under the Good Samaritan. You keep going until you can't anymore physically or somebody's there to take over. If you're in a group, after every five sessions, you're doing compressions, the other person is doing breathing, then you switch, then that person does compressions and you do breathing. If there's a whole group, you guys keep just round robin it until help arrives. But if you're by yourself, keep going until you physically can't anymore.

Darleen Mahoney [00:22:05]:

Right? Right. And I know that adrenaline probably has people providing them more of that ability than no adrenaline, for sure. So when you're in a life saving position, it can change every aspect of how you conduct yourselves and how you actually feel, as if, you know, versus any regular day. So how long, if you were to decide to do a CPR class, how much of a time commitment is it? How much is it on an average cost? I know that you provide these classes in South Carolina and Florida, but we have listeners all over the country that might be very interested in finding something in their area. So what are the expectations generally on that?

Joel Holly [00:22:52]:

So there are a lot of places that provide free hands on the hands only CPR. But to learn about the ad, some first aid, and the breathing and all that. Classes typically run about $65. Or if you're going heartsaver, and I'll tell you the difference in a minute, they run about 7580. BLS is the one that people typically do. It's about three hour class, 3 hours, 40 minutes. And it's usually for healthcare because they're doing so much in their facilities, they have in services where they're. They're constantly in emergency situations, or they have people coming in.

Joel Holly [00:23:36]:

It's more of the team dynamic and a review of CPR. Whereas heartsaver goes over CPR breathing of some first aid, and it's more for non medical, so they have more of an understanding of the overall bleed control, seizures, CPR. There are a lot of different organizations that do CPR. American heart. This one that we teach HSI, which is health safety institute and Red Cross, are usually the top three that if you are working in the field, those are one of the three that they're going to require. Civilian. They are some of the better ones. They are more tested, more known.

Joel Holly [00:24:30]:

I say to anybody that wants to take a class non medical, either or is good, it's the instructor and how they focus on their training. If they are just in it to try and get as many people as they can get in, get out, it's not worth your time. You want more hands on in a class than video. You don't want to sit there for three and a half hours listening to video. And then you hear that voice from Monsters, Inc. Any questions? And then keep going on. It's not worth your value. You want that hands on experience.

Joel Holly [00:25:13]:

I've had people in my class go, this was a masterclass. I've done this over and over again. But this is the first time I've understood what's going on. And I have skills because that's the important part. Written tests are not going to save lives.

Darleen Mahoney [00:25:27]:

Right?

Joel Holly [00:25:28]:

The actual skills. The video is not going to save lives. I can give you references to tons of videos on YouTube that you can watch. But if you don't know the hands on, what good is it?

Darleen Mahoney [00:25:41]:

Exactly? YouTube? There's a lot of things that are on there. I know my son learned how to fix my Dyson off of a YouTube video, and I'm super grateful for that because he saved me a whole lot of money. But when it comes to saving lives, I would think you want that hands on experience and then the expertise that would come with it. So looking at anyone that's listening in your area, probably looking for those different types of things with American Heart association, but also looking at the Google reviews of those classes, because if someone's having not the best experience or didn't think the instructor was up to par, they're gonna talk about it. So I think kind of looking through some of those Google reviews will also help kind of narrow down a good place to get that certification for me, when I hear about CPR, and clearly our podcasts are geared towards seniors and their caregivers and their families, it seems to me, just in general, anyone should take that extra step and get certified. But if you're caring for an elderly person in the home and that's your job, or that's the main thing that you're doing, even if they're your family, I think it's really just a no brainer to go spend the time. And it's. I mean, you said that the amount that it costs, and to me, that is super affordable.

Darleen Mahoney [00:26:59]:

I mean, it really is. And it's just worth its weight in gold to be able to go get those basic skills. And you're not even just talking CPR. You're adding additional layers of help that someone might need in an emergency situation in the home or out in public or on a plane, whatever the case may be. So I just kind of think it just. It's just 101.

Joel Holly [00:27:25]:

It's a skill that you would rather have and never need than need and not know or not have. And like you said to me, $65, $75 for heartsaver for a couple of hours one day every two years, but one day, it's something that's invaluable.

Darleen Mahoney [00:27:48]:

Yeah, absolutely. Absolutely. And it's so strange because I just don't know a lot of people that invest their time in it. So I like that we're getting the word out on it and hopefully encouraging some folks to get that CPR training and understand how important it is to save. I mean, it could be the love of their life that they save. It could be a child, it could be their grandchild, it could be their grandmother. So if you look at it from that aspect, versus I could save some stranger's life off the street, you may be doing that. That might be what ends up happening once you get that skillset, but the reality is it's probably going to probably be someone closer to home and closer to your heart.

Joel Holly [00:28:37]:

That's typically how it happens. And it's such a reactive thing. You don't know until it happens, and then that fear of, oh, my goodness. And the survivals get guilt. Excuse me? So many other things run through your head. When I had that opportunity, I didn't think it was worth it. And now I'm in panic mode.

Darleen Mahoney [00:29:00]:

Yeah. Yeah. That's heartbreaking to even think. Well, let me ask you this. Before we sign off on our podcast, did you have any closing thoughts or remarks?

Joel Holly [00:29:14]:

I just want to let everybody know that it is important to be proactive in anything and everything that you do. My dad tells me, you know, plan for the worst, hope for the best. It's. It sounds pessimistic. Until you kind of take a look at what it's really saying is you never know what life is going to throw your way. Be prepared for it. And hopefully people have made those steps. If they don't, there are people out there that can help you in anything and everything.

Joel Holly [00:29:52]:

So I just want everybody to be safe.

Darleen Mahoney [00:30:27]:

Well, I did want to share your information so that our listeners can get in touch with you. So please share your contact information if you like, and then also your website URL. The upside is, is it will also be included in the copy of the content of the blogs. Or not the blogs, but the podcast itself. So they'll be able to click on it and get straight to you. But please share that just for our listeners.

Joel Holly [00:30:49]:

We are@hollysafetygroupl.com that's our email. That's h o l l e y. Our website is the same, hollysafetygroup.com, and our phone number is 3214-448-4343 perfect.

Darleen Mahoney [00:31:06]:

And do not forget, he said holly with h o l l e y. Gotta remember that part because it gets fancy over there.

Joel Holly [00:31:16]:

So blame your grandparents.

Darleen Mahoney [00:31:20]:

I know, right? Right. Well, thank you so much for joining us today, Joel. We really appreciate the information that you've provided. We really appreciate the services that you're doing for senior living communities, the facilities, and folks that just generally want to get certified and get more knowledgeable on how to save lives.

Joel Holly [00:31:40]:

I appreciate you guys giving the opportunity to educate people on what they need to do, safety, and things that they may have never considered.

Darleen Mahoney [00:31:50]:

Absolutely. Thank you so much. And thank you for listening today. If you enjoyed this podcast, we have several other podcasts, over 80 actually, and they can be found anywhere you listen to podcasts, including Spotify, Apple podcasts. Good pods. We're available on babyboomer.org dot. Thank you for listening.