Announcer (00:02):
Coming to you from Corewell Health, this is your HouseCall.
Dr. Asha Shajahan (00:13):
Damar Hamlin, NFL Player for the Buffalo Bills, suffered a cardiac arrest during a game. He was down for allegedly 19 minutes. Hamlin required an automatic external defibrillator, an AED, in addition to CPR on the field. Team members, paramedics, they were able to restore Hamlin's heartbeat before he was taken from the field to a university hospital. At this year's Super Bowl, Damar walked on the field, breathing, walking, smiling, with an entire stadium, cheering his recovery. But what kept Damar alive? You're about to find out.
(01:02):
Hello, and welcome to the HouseCall Podcast. I'm Dr. Asha Shajahan. Our goal is to help you and your families live smarter and healthier lives. Today we're going to talk about how you could save someone's life through CPR, and also the importance of student heart checks. Joining us today is Jennifer Shea, Beaumont's Student Heart Check manager at Corewell Health in Southeast Michigan. So welcome, Jen.
Jennifer Shea (01:27):
Hi, thanks for having me today.
Dr. Asha Shajahan (01:28):
Yeah, I'm so excited to have you join us to talk about such an important topic that's just really been... Especially since Super Bowl just finished, everyone's been buzzing and talking particularly about Damar. And just watching that on... I don't know if you watched it.
Jennifer Shea (01:42):
I did watch it, yes.
Dr. Asha Shajahan (01:43):
Yeah, when you were watching that, I think everyone was just silent and, "Oh my gosh, what is happening?" People were so concerned, and it was a scary moment for everyone to watch.
Jennifer Shea (01:53):
Yes.
Dr. Asha Shajahan (01:54):
But thanks to CPR, which is cardiopulmonary resuscitation, Damar's with us today.
Jennifer Shea (02:00):
He is, yeah.
Dr. Asha Shajahan (02:01):
And the interesting thing is, is I was looking at some stats and they say close to about 350,000 cardiac arrests occur outside of the hospital every year, and 90% of them are fatal. And this is according to the American Heart Association. So part of the way that we can increase survival is through early intervention and AED intervention. So let's debrief. What exactly do you think happened with the Damar situation?
Jennifer Shea (02:31):
So what I do know is that something happened to cause his cardiac arrest. We're not sure what that is yet because it hasn't been released. But what helped save him was that quick response that he had from his team that was around him. They immediately recognized the need for CPR. They immediately had the AED on him, and it was able to shock his heart back into a regular rhythm for him to be able to be transported to the hospital and cared for further by the doctors and nurses there.
Dr. Asha Shajahan (02:56):
Yeah, and so as a physician, when we do CPR, one of the first things we want to know is how long someone had been down for. And so why is it so important to have this immediate CPR?
Jennifer Shea (03:08):
When the heart's not pumping, then blood is not circulating the body, oxygen's not going to the brain and other vital organs, so that's when our organs start to die. So the quicker we can have CPR, which moves the blood around the heart and the brain and the body, and if we have an AED available to be able to shock the heart back into the rhythm it's supposed to be, the better chance of survival we have.
Dr. Asha Shajahan (03:30):
Yeah. Can you talk a little bit just for the general public, AED, like what is that? And I know you mentioned that it's shocking the heart, but what exactly is the device? How does this work?
Jennifer Shea (03:38):
A lot of times when you're out and about, you should try to look for them. They're usually in a white box on the wall. And what it is is a piece of equipment that you can remove. Anybody can use it. And when you turn it on, it gives you instructions on how to use it. So what it does is you place stickers on the person's chest, and the stickers show you exactly where to place them. It can detect whether the heart is beating in a normal rhythm or not beating in a normal rhythm. And if it's not beating in the rhythm it needs to be, it can advise that a shock be given to that person, which will restore the rhythm, along with CPR, to that person.
Dr. Asha Shajahan (04:12):
So, Jen, you do incredible work, incredible work. I mean, what you do saves lives, and it must be just so rewarding. Share with our guests, what is it that you do?
Jennifer Shea (04:23):
So beyond doing student heart checks, which we'll talk about a little bit later, I help schools become Michigan HEARTSafe School designated, which means that they have gone through the extra steps needed to help prepare in case of a cardiac emergency on campus. Those steps include having a certain number of staff in the school overall certified in CPR. All head coaches, all PE teachers have to be CPR certified. They have to have working AEDs and enough to cover the area of their school. And they have to create a cardiac emergency response plan and team, and practice with that team with an AED drill, which means that they have gotten together and they've learned their plan enough to be able to execute it in an unannounced drill kind of a way to make sure that the AED gets to the person in time, that high quality CPR was started, that all the chain of survival was followed.
(05:10):
And when schools do all that, they can apply for this designation from the state that is good for three years. We're currently working with 25 different schools and school districts to help them get certified for this school year. But I go out to schools all the time and assist them through that process. We offer CPR certification to the teachers. We can do that for a low cost of $10 a teacher.
Dr. Asha Shajahan (05:32):
Amazing.
Jennifer Shea (05:33):
All this because we have philanthropy funding our program that gives us the ability to do all these different initiatives in the community to help reduce deaths from cardiac arrest, hopefully.
Dr. Asha Shajahan (05:43):
Yeah, high five to those philanthropists. And hey, if you're listening and you want to donate, I would say that's an amazing thing that people don't think about. You know, like a Christmas present, in honor of a loved one that passed away, is getting AEDs in schools or getting people certified in CPR. I think that's a philanthropy moment that we don't often think about.
Jennifer Shea (06:06):
Yeah, think of how many hours our kids spend in school a day and then add sports on top of that. And we want those people that are surrounding our kids to be prepared for whatever might happen, not even just for the children there, but for anybody who might be in the building, or teachers themselves.
Dr. Asha Shajahan (06:22):
Right. Many people might witness someone collapsing or going into cardiac arrest and they just don't do anything because, one, they don't know what to do. Second, they might say, "I'm waiting for an AED," or, "I'm waiting for help," or whatever. We know that the earlier you intervene, the better.
(06:41):
And so I've got a story to tell you, actually, about a CPR situation that happened outside of the hospital. So it was late at night and I had just come off a night shift, and I was so tired. I was living with my parents at the time, and so I had gone into my bedroom and literally got into bed, and I heard this thud, and I was like, "What is that?" So I run downstairs and I see my father laying under the kitchen table, foaming from his mouth, and just appearing unconscious.
(07:11):
So I completely panic. Even though I'm a physician, I mean, everyone just panics. I don't have a whole team around me. I don't have an AED. I immediately just run to the phone and call 911 and I just left it off the hook. I immediately started to check him for his signs and realize that he's not breathing, no pulse, and I immediately started just chest compressions. And luckily, thank God, he revived and help arrived, and he's doing fine and fantastic, and this was over nine years ago.
Jennifer Shea (07:43):
That's wonderful.
Dr. Asha Shajahan (07:44):
But I always remember that in the sense that chest compressions are really important.
Jennifer Shea (07:49):
They sure are.
Dr. Asha Shajahan (07:50):
And people who are not maybe comfortable doing CPR, not really understanding CPR, nervous about it, they can do two hand compressions. So can you walk us through that a little bit?
Jennifer Shea (08:01):
Sure. One of the most important things you did was call that 911 right away, because we want to get somebody there with advanced life support as fast as possible. But then the next step is to assess what's going on with the person. I teach people we have two things we're looking for. Are they responsive to you? Do they answer when you call their name? Tap them on the shoulder, ask them if they're okay.
(08:20):
And are they breathing normally or not? That's the second thing. You don't have to worry about pulse when you're a person in the community just trying to help. We're looking at how they're breathing. If they're doing anything but normal breathing in and out like we normally are, if they're making any kind of funny noises, if they're not breathing at all, if they're gasping, that's not normal breathing, and that means they need CPR.
(08:42):
And really all we need people to do is push firmly on their chest, right in the middle of their chest, both hands, 100 to 120 beats per minute... There's songs that we'll go over in a minute about that... about two inches down. And once you start compressing that chest, that starts the pump in the body that brings the oxygen back to the brain like it's needed. And so we need to continuously do that until other help arrives. The faster we can start pumping the heart, the better chance of survival that person has, so we don't want to delay doing that. You don't have to breathe in their mouth. We need to, though, get their heart pumping again.
Dr. Asha Shajahan (09:13):
Yeah, and I think that's one of the biggest misconceptions, is like, "Okay, I have to tilt their head, I have to breathe in their mouth. I have to do all the-"
Jennifer Shea (09:20):
Put my mouth on theirs, yeah.
Dr. Asha Shajahan (09:21):
And you just panic. But it's funny that you mentioned the songs, because I did take a CPR training class. So this is just part of regular CPR training, the same type of training that any layman would take. And they had told us that you do the chest compressions to the song Staying Alive.
Jennifer Shea (09:39):
Yes.
Dr. Asha Shajahan (09:41):
And when that occurred to my father, that was the first thing, oddly, that came to my head-
Jennifer Shea (09:46):
Really?
Dr. Asha Shajahan (09:47):
... when I was doing the chest compressions. Because at first I was panicking and I just wanted to just go hard and fast and was just trying to see if he was okay. It was odd that that song came to my mind and I was able to do it to that rhythm. And it's like somehow that just sticks in your head.
Jennifer Shea (10:02):
Yeah. Spotify actually has a whole playlist that you can download of all kinds of popular songs that are in that same 100 to 120 beats per minute rhythm. And for our parents out there, Baby Shark is also one of those songs.
Dr. Asha Shajahan (10:15):
Baby Shark.
Jennifer Shea (10:16):
Yep. And then a bunch of those team theme songs like the Go Blue: dun dun, dun dun dun, same rhythm. So there's lots of songs out there. If you can find one that speaks to you, that might help you in that circumstance to help you keep the rhythm. Sometimes people push too fast because they're nervous, or they push too slow, so having that rhythm in your head really helps.
Dr. Asha Shajahan (10:37):
Another thing, people are always worried about things like, "What if I break a rib?" Or, "What if I cause more damage than harm?" Thoughts on that.
Jennifer Shea (10:44):
Well, you have to think about the reason why you're doing CPR at that moment, is because that person isn't alive or they're not going to be able to sustain life very long. And so if you were to do nothing, they would not be alive. If you're doing something, you can have a chance to bring them back. And they might have a little bit of bruising injury, maybe a broken rib, but that's something that can be fixed and healed much better than not doing anything because you're afraid of hurting them in that way.
Dr. Asha Shajahan (11:09):
Yeah, I would take a broken rib over something else.
Jennifer Shea (11:13):
Absolutely. Yep. And we're covered by this Good Samaritan law, so if you do step in to help somebody, they're not able to sue you because you tried to help them.
Dr. Asha Shajahan (11:19):
Absolutely. Okay, so now you got me more hyped about getting more people to do CPR and learn CPR. Where can someone get trained if they want to?
Jennifer Shea (11:29):
So you can look up classes online. Just google local CPR classes. A lot of times American Red Cross or American Heart Association has classes in different places. Sometimes schools, community centers, churches, mosques, temples have classes. And so probably the easiest thing to do in your own community is to google local CPR classes and find out what's available near you.
Dr. Asha Shajahan (11:51):
One of my friends is from Germany, and they mandate when you take driver's ed that you have to be CPR certified.
Jennifer Shea (11:56):
I think that's amazing.
Dr. Asha Shajahan (11:57):
Yeah. I was like that-
Jennifer Shea (11:58):
I wish they did that more here.
Dr. Asha Shajahan (11:59):
Yeah, we should do something like that. We should get that started. But anyways, okay, so that's awesome. So we talked about CPR, the importance of CPR, why it matters, because it saves lives. Along that same track, when we're talking about saving lives, when we saw Damar's incident, I know there was a lot of chatter in my office from parents worried about their kids playing contact sports, and like, "Oh gosh, I don't know if they should. I'm going to take them for their sports physical." And I mentioned to them they could do a student heart check. And so can you walk our parents through what is a student heart check and how is that different than just a regular sports physical?
Jennifer Shea (12:40):
So Beaumont, since 2007, has been doing the Student Heart Check program. It's a free program for kids in the community to be able to have their heart screened with tests that aren't provided in a local sports physical. So when they come into a screening, it's absolutely free. We do them at different local schools in the area. They get their blood pressure taken just like they do at the doctor's office. They learn how to do hands-on CPR and how to use an AED so they can leave the screening knowing how to save somebody if they need to.
Dr. Asha Shajahan (13:06):
That's amazing.
Jennifer Shea (13:07):
Yeah. And then they get an EKG, which is just where they put those tabs on your chest and they're looking at the electrical rhythm of your heart to see if there's any abnormalities in your heart rhythm. The doctor comes and does a history and physical, talks to you about any symptoms you might have or family history that might be concerning. Also listens for murmurs like you do at a normal doctor's office visit. And then they do a quick look echocardiogram, which means a ultrasound of the heart. So a little bit of gels applied to the chest and the doctor watches a screen that shows your heart and the different valves of your heart and the thickening of the walls and looks for different abnormalities that way.
Dr. Asha Shajahan (13:42):
So right there you said three things that is not included in a sports physical, because I do sports physicals all the time. We don't do echoes. Normally do not do an EKG. And also, we don't teach people how to do CPR and use an AED, which I think is fantastic. So that sounds really like something that I think everyone should probably have. I know I would probably want my child to have that. But again, some people wonder is that too much? Is it overkill? Are they just going to find things that are just going to lead us down a rabbit hole and make us worry about stuff?
(14:16):
And I always tell them the echo is really important, particularly because they can see how the heart is, if the heart's enlarged, if it's beating correctly. And same with the EKG. It can tell us if there's rhythms that are abnormal and also other things that could be abnormal: pericarditis, hypertrophic cardiomyopathy.
(14:35):
So along those lines, can we just tell our listeners a little bit about what hypertrophic cardiomyopathy is? Because that's something that is worrisome when we think about kids playing sports.
Jennifer Shea (14:46):
Yep, right now, hypertrophic cardiomyopathy, also called HCM... A little easier to refer to it that way... is the leading cause of death for student athletes. It involves the heart thickening at an abnormal rate, which causes it to not pump properly. And over time, it gets to a point where it doesn't pump enough that it goes into a rhythm that's fatal.
(15:08):
And so it's very important for us to be able to test for that, to be able to find those kids that have their hearts starting to thicken, before they get to a point where something happens, not only on the sports field but maybe at home or whatnot. We never know when a cardiac arrest might happen because something is abnormally wrong with the heart.
Dr. Asha Shajahan (15:27):
And then there's a certain age to get a student heart check, right? Because the younger kids, your kids are in soccer at 5, 6, 7, this is not necessarily something that would probably benefit them. Around what age are we looking at?
Jennifer Shea (15:39):
We base our program off of looking for that HCM, so our program runs for kids age 13 to 18, because during puberty is when we more often see the heart in that rapid growth period thickening abnormally. And so we base that off of that condition we're looking for. We find all kinds of other conditions. And then also it helps concentrate the kids that are asking for screening, because the demand is high and we do as much as we can.
Dr. Asha Shajahan (16:07):
And then screening is just once a year or just once... How does that work?
Jennifer Shea (16:11):
So because these kids are now in just such higher impact sports, higher velocity sports, when they get into that high school range, we recommend that once you have a screening, that you follow up every two years while you remain in those high velocity sports. So say you have one at 13, I would get checked at 15, at 17, if you can, because the body... You know how much your children change in that five years span of time. They're completely different at 13 than they are at 18, and so is their hearts and their bodies too.
Dr. Asha Shajahan (16:39):
Okay. And the cost is completely free, at least for the one that's offered through the Beaumont program.
Jennifer Shea (16:44):
Yes.
Dr. Asha Shajahan (16:44):
And then for CPR, what's the average cost, you think?
Jennifer Shea (16:48):
So I think in the community it's about $50 to get certified in CPR. It ranges depending on where you decide to go and what they're charging. But I think on average $30 or so is how much it costs if you're going to get certified, which is a two-hour class. But anybody can learn how to do Hands-Only CPR. It doesn't cost anything at all. There's tons of videos online. There's so much information out there. Really, it's just knowing where to place your hands and pushing hard and fast in the middle of the chest.
Dr. Asha Shajahan (17:13):
Do you have a good website that people could... Will YouTube help?
Jennifer Shea (17:16):
YouTube has a lot of great videos, so if you just go on YouTube and look for CPR instructional videos, there are so many different companies that have put out amazing information there.
Dr. Asha Shajahan (17:26):
Yeah, that's great. So any last thoughts that you want to share?
Jennifer Shea (17:31):
I think beyond people being certified, we want to make sure our schools know how to respond. We've had incidents in Michigan so far, where a couple kids have been saved because someone was there at the right moment, knew exactly what to do, had a AED brought immediately, and those children were able to go home after their stay in the hospital. And we've heard from across the country, unfortunately, kids who didn't have that same response, more recently, where nobody knew how to do CPR and they were just there until EMS came, and by then it's too late.
(18:02):
So we want to make sure our sports teams, our coaches are CPR certified. They really should be certified more than just having the Hands-Only part. We want our schools and our sports teams to have access to AEDs and have a practice plan, an AED drill that helps them all practice together, just like Damar had, where his team practiced together multiple times a year. So when that moment happened, they didn't have to think. There's no panic. They already knew what they were doing. Just like we do in the hospital, we practice over and over again. So it's so important for schools and teams to be prepared in that way.
Dr. Asha Shajahan (18:35):
I think that's great. And like you said, practice is important. And so think about it, 30 bucks to be officially CPR trained every two years, get re-certified or so. 30 bucks is like going out to dinner these days. It's like saving someone's life, saving your loved one's life, it's a big deal. Jen, any resources that you have for our listeners on how to get a student heart check, where to go?
Jennifer Shea (19:02):
We have a website, beaumont.org/studentheartcheck or slash shc. Either one will get you right to our website that gives you information about the number of screenings we've done. It's got videos about what a screening's like. And then when we have events, we post them there, along with registration links that you can go to if you want to sign your child up.
Dr. Asha Shajahan (19:20):
Wonderful. And then also, the American Heart Association also has resources in terms of CPR learning, how to do CPR and that type of thing.
Jennifer Shea (19:27):
Yep, they do.
Dr. Asha Shajahan (19:28):
Wonderful. Well, thank you so much for joining us. Great conversation. Keep doing amazing work.
Jennifer Shea (19:34):
Thanks.
Dr. Asha Shajahan (19:35):
And thanks for all you do. It's truly inspiring.
Jennifer Shea (19:37):
It's been an honor. Thank you very much.
Dr. Asha Shajahan (19:42):
We leave you today with this healthy thought. Currently, about 9 out of 10 people who have cardiac arrest outside of the hospital die, but CPR can improve those odds. If it's performed in the first few minutes of a cardiac arrest, it can actually double or triple a person's chance of survival. That's huge.
(20:05):
You don't need a special certification or formal training to perform Hands-Only CPR, but you do need education. If a cardiac arrest happens to someone near you, don't be afraid. Just be prepared. Follow these steps if you see someone in cardiac arrest. Call 911 right away. And then give CPR if you see that someone has labored breathing, you see that they are unresponsive. What you can do is push down hard and fast in the center of the chest at a rate of 100 to 120 beats per minute. We mentioned a couple songs that were around that same rhythm, such as Staying Alive or Baby Shark. Find what works for you. And then continue giving CPR until a medical professional arrives.
(20:50):
You can be that person with formal training as well. Jen talked about getting classes done, and also getting your child screened with a student heart check before enrolling in sports. We know that CPR does save lives. CPR saved my father's life, and it can save someone you love too.