Last month was Sudden Cardiac Arrest Awareness Month, as well as the American Heart Association's 2025 Scientific Sessions – which Kristin attended as a social media moderator! So in this month's deep dive, she reflects on her experience co-surviving Will's cardiac arrest, and how it's informed her view of CPR training and bystander trauma.
This essay breaks down her thoughts about how we can better support lay CPR responders and co-survivors through the under-recognized trauma of trying to save someone's life during a medical crisis – especially a loved one.
We really hope this resonates with you, and inspires some change in the way CPR training programs are currently run. ❤️
Enjoy,
The Glaucomfleckens
How Can We Make CPR Training More Human?
An episode of our podcast from last month that talks more about this topic!
With October – Sudden Cardiac Arrest Awareness Month – freshly in the rearview, I’ve been thinking a lot about bystander intervention. That is to say, the everyday people who perform CPR when they witness a sudden cardiac arrest.
Will was one of the roughly 350,000 people each year who experience a sudden cardiac arrest outside of a hospital setting. While I was able to save his life through quick action and CPR, about 60% of people who experience an out-of-hospital cardiac arrest (OHCA) don’t receive bystander intervention. This is a serious problem, especially when you consider two things:
1) OHCA survival rates currently hover just below 10%.
2) Hands-only bystander CPR has been seen to double or even triple those survival rates.
I’ll always advocate for CPR’s truly lifesaving power, and there are plenty of public health campaigns already encouraging people to complete training and certification programs. But at the same time, I’ve seen firsthand how our current training models have some blind spots.
We need training that considers both the human experience and the science. Current CPR training methods inadvertently make three key mistakes that leave bystanders and lay responders unprepared for the moment of crisis and its aftermath.
Hre’s whow I would address them.
#1: Lack of preparation for the sensory experience
Performing CPR is one of the most bizarre and terrifying sensory experiences I’ve ever had.
You might feel your hands crushing or even cracking the person's ribs as you press down hard and fast. There’s a tension in their chest as it depresses and springs back up to the rhythm of your compressions.
Nothing has ever felt like that since. Frankly, I hope nothing else ever does.
What’s more, when you witness someone in sudden cardiac arrest, you are literally witnessing the person dying. Their body doesn't move or respond the way a human's should, and their skin turns deathly colors of blue, purple, and gray. They might make guttural, ragged, snorting sounds as their brainstem tries and fails to tell their lungs to gasp for air. The sound of Will’s agonal breathing still lives in my head to this day.
These visceral realities were never really covered when I received CPR training. But even if other programs do cover them, nothing but experience can really prepare you for this.
You’re never ready for a real-life horror movie to unfold in your bedroom.
Knowing this, it’s an admittedly tall task for instructors to deliver. But something would be better than nothing – perhaps a video from a real life experience.
While the terrible memories of those sensations would still be there, co-survivors would be better equipped to process them with a realistic view of how sudden cardiac arrests unfold.
#2: Teaching only from a clinical perspective
Most CPR training and certification programs feel very clinical. People need to understand the nuts and bolts of recognizing and responding to a cardiac emergency.
This includes teaching points like:
- Signs that indicate a cardiac arrest is occurring
- How to call for help
- How to correctly perform chest compressions
- How to use an AED
But while this information is critical, it isn't complete.
Sudden cardiac arrests are, well… sudden. Very different from a planned practice session on a mannequin already flat on its back on the floor of a well-lit classroom or conference space.
Ok, I guess I don’t have specific numbers on how many cardiac arrests actually happen under fluorescents, but my point remains.
This is all to say that while the training prepares you to take action, it doesn’t really prepare you for how a sudden cardiac arrest happens in real time.
It was the dead of night when Will’s SCA occurred, so our room was very dark. I wasn’t able to move him to the floor, so I had to start chest compressions against the give of a soft mattress – making it all the more difficult.
I’d like to see CPR training programs do a better job of addressing the different scenarios in which sudden cardiac arrests occur, so that we aren’t at risk of freezing up with uncertainty.
#3: Ignoring the Trauma Associated with Performing CPR
Talking to Avive about my SCA lay responder experience, 2022.
Around 70% of out-of-hospital sudden cardiac arrests happen at home. This means that most people who witness and respond to cardiac emergencies are family members, friends, and loved ones of the victim.
Performing CPR is traumatic in the best of circumstances, but it's even worse when the person you are trying to save is someone you love. Someone with whom you share years of memories. Someone with whom you’ve built a life. Someone your children need.
When we run public health campaigns to convince people to learn CPR or sign up for training sessions, we need to recognize this.
The truth is, lay responders can’t ever really be emotionally prepared to respond to their worst nightmares unfolding in real life. Thus, the onus shouldn’t be on them to figure out how to recover from that trauma alone.
Instead, we need to set up robust support systems and resources to help responders navigate the aftermath of performing CPR.
t will save lives and give lay responders an understanding of the healing experience that must be supported afterwards.
CPR saves lives, and it's not just noble to teach people how to do it – it's essential.
But as we consider the lives we are trying to save, we must also remember the mental health of the responders. If we are going to ask people to take action to save a life—and we should—it is our moral imperative to support them when they do.
This begins by addressing the gaps in current CPR/AED training programs that leave us unprepared for the realities we’re experiencing.
In Last Month's Issue
With fall finally here and winter on the horizon, a lot of us (and our patients) are beginning to feel – or dread – the effects of waning daylight hours and cold weather.
For last month's deep dive, we tapped Margaret Duncan, MD (1/2 of How To Be Patient – a podcast we executive produce!) to share some psychiatrist-approved tips for keeping your mental health at the forefront this season.
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