 in the studio here at Davis Media Access. Today, I'm your host, Emily Merton. And joining me, I have Kristin Wiboda and Jennifer Meadows from the Yolo County Emergency Medical Service Agency. And they're here to talk about the new form of CPR that has been kind of performed and regulated and what's changed about CPR. So thank you so much for being here today. So do you wanna start out introducing yourself in just your individual role at the Emergency Medical Services Agencies? Sure, I'm Kristin Wiboda. I oversee all the emergency medical services in Yolo County. So anything that has to do with 911 and our first responders and the hospitals that we go to. Awesome. And I'm Jennifer Meadows. I am an EMS specialist with Yolo County EMS. I implement exactly what Kristin lets out. Okay, perfect. So what has changed about CPR? What is the main thing that has changed and when has it changed? So it actually ended up changing in 2010. And the idea behind it was to try and increase bystander CPR. So when someone collapsed of sudden cardiac arrest that why aren't people doing CPR? And so they changed the guidelines to increase people wanting to do and wanting to perform CPR. And so now it's simple and more people are hopefully getting out there learning and performing CPR. All right, so what do you think is the reason that people are more likely to do this new form of CPR? What's different about it? So they made it simple so there's less steps to follow. The other thing that they did is they took away some of the scary factors. That idea of having to breathe into someone's mouth. The idea of having to check all sorts of things before you start. Now it's just really simple. If someone's unresponsive and you can't tell if they're breathing or has a heart rate, now you just start doing compressions. And that's the only thing you have to focus about. So there's nothing else that you have to think about of, oh, do I open the airway? Do I check for breathing? Do I feel appalled? So you don't have to do any of that anymore. Now it's just start compressions and continue compressions. Okay, well, was there a concern that this is less effective as before since there are less steps? Why is the change, why is the change okay? So for people who took CPR before, everything was always taught that we did ABC, airway breathing circulation. They thought those were the three priorities that had to be addressed in that order. And what they found in 2010 is that that's not the case. The most important thing when your heart stops beating is to start circulation again. And the way you do that is by doing compressions and then airway and breathing comes later. So what they found is if we can get people starting CPR early, the better chance someone has at surviving because they have more circulation to their heart and the brain by just doing compressions. Okay, so how are you guys letting people know about this change? Because I know myself, I didn't know about this change and it's been a while. So what do you guys plan on doing? So it's kind of a multi-tier response that we're doing here. We've been rolling out training to our fire departments to make sure that they understand that they can be doing this outreach every day, that it's not a certification anymore and that anyone could teach hands-only CPR if they've been trained in other CPR. Then the next thing that we're doing is we're looking at different ways to implement tools to help people learn this. So we're implementing something called PulsePoint across the county, which is an app that you can download that notifies you when someone collapses of cardiac arrest and with that we're hoping to partner with our fire department so that the fire departments can go out, teach hands-only CPR to their citizens and then everyone can download the app and then have access to know when someone collapses of sudden cardiac arrest. Okay, so tell me a little bit about the process of just what you do, just like the compressions is how far down are you supposed to compress? When are you supposed to start? What position should the person be in? Well, it's been simplified quite a bit. So like Kristen was saying, it was complicated before. Where do I even breathe? How do I breathe? Do I move their head? Where do I even put my hands? So things are pretty simplified. My recommendation, you want to expose what you're looking at, lift the shirt or if they don't have a shirt on it kind of makes things a little bit easier. Your hand placement, one on top of the other, it goes right in between the nipple line and you compress. You want to compress probably about half of their body and that's what you're using. Your heart lives behind your chest wall and those bones are actually what's going to use that mechanism to push down and to make the blood flow around the rest of your body. So that's really all it is. Okay, is it different for children or infants because I know before the compression was a little different? It is different. So for a child, the recommendation is the heel of a hand but if you're working with a child who's a little bit bigger, maybe somebody who's even 10 to 12 to 14 years old, sometimes those are big kids. So use your best judgment. If you feel like the heel of your hand is not making the compression, utilize both hands and be aware of how far you're compressing. Children, or the infants, there's the circular approach or you can use the two fingers. Either one is fine. But they are recommending that you do the same amount of compression. So what they're saying now is that you want to get at least 100 to 120 compressions in per minute no matter what the age is. Okay, and that's to the beat of staying alive. Staying alive, yeah, that always helps me out. And just keep going. All right, keep going. So the first thing you do when you see someone lying on the ground, do you call 911 first? Do you check their breathing? What's the first step? Well, you obviously, I mean, you would want to shake and shout them to some degree. You would want to figure out if they were responsive or not. But we're gonna wipe out the rest of that stuff. If they are not responsive, activate 911 and start CPR immediately. There's no give time in between. And oftentimes you will hear families frustrated or scared after an event, such as their loved one in a cardiac arrest. I didn't know how to do it. I didn't know where to start. I didn't know where to put my hands. There's too many things to do. So hopefully this simplifies things. And in the long run makes everybody, not only the outcomes, but put people at ease a little bit more. Definitely, it does seem a little less scary to approach something when there's a lot less steps involved. So have you heard any response about this, about the new version working more, more people willing to volunteer to do the chest compressions? In Yellow County, since we're just rolling this out, we haven't had as much response, but we're hoping to be able to track that information and see what kind of response we can get. But throughout the Bay Area, this has been in, they've implemented it over the past handful of years and they've seen an increased number of bystanders doing CPR. And they've also seen an increased number of people surviving from sudden cardiac arrest by implementing these simple new guidelines. That's great. That's wonderful. So talk about PulsePoint a little more, the app, how does it work? So PulsePoint is an app that interfaces with the 911 Dispatch Center. And what happens is when a call comes across for someone who possibly is not breathing or anything else that could lead the dispatcher to think that this person could be in cardiac arrest, it links to the app and it can only happen in public places. So no one at home is gonna get a notification that someone next door is in cardiac arrest. But if you're out in a public place and the 911 call goes in, it automatically links to the app and anyone who has downloaded it, who's in a radius near that person will get a notification on the phone that says cardiac arrest, CPR needed and it gives the address. And then they can respond and perform CPR if they choose to. And it's loud enough. You won't miss it if you have the app. Okay, so how are you guys planning on getting people to download this app? Is it still in process? So anyone could download the app right now. The only thing is, depending on where you live in Yellow County, you would not get the notification because it's not set up all the way throughout the county. But once the app is set up with our dispatch center, what we're gonna be doing is using the fire department as one of our main vessels to go out and go to schools, do public events, teach hands only CPR and then encourage people to download this app once they learn how to do CPR. All right, so is CPR certification needed for anyone anymore? Like if you're going into training to be like a lifeguard or anything like that. If you're going into be training for lifeguard, babysitter, healthcare, things like that, the certification is still required. But for anyone else who just wants to learn CPR, it is not required anymore. You just do the hands-only CPR. You can look at videos online. You can reach out to your fire department or anyone else to learn how to do just hands-only CPR. Okay, so why would someone want to learn the old version of CPR compared to this new one? Why is that still being taught? The old version is not the same way anymore either. It is still simplified. It's still focused on circulation and depending on your training level, it gets either more complex or less complex. So if it's someone who's doing this for babysitting, it's gonna get into some more details about choking and airway issues. But it's still gonna teach the same idea of focusing on good compressions and worrying about the airway and breathing later. And so it just gets into a little bit more detailed instructions at the end of the day. So what is the main difference in the old CPR? How was it modified to make it more based on the circulation? So old CPR talked about making sure that the airway was open and that you confirmed that by giving two breaths and making sure that the breaths went in and you looked for rise and fall of the chest. After you looked for rise and fall of the chest, then you would go to feel if you could feel for a pulse. If you couldn't feel for a pulse, then you would start CPR. So the delay before CPR would get started was huge. Now we skip those things and we go straight into compressions to start the circulation. So it's just a reorder of priorities during CPR, then really changing anything. And then the next thing that they really changed is there used to be different rates. So if you were an adult, you compressed at this rate. If you had one person versus two people, you did things differently. And then it changed for kids and it changed for infants, which was really confusing for people to follow. Now there's just one standard across the board that no matter how many people you have there, you are just focusing on your compressions and there's no confusion to how you need to change it. All right, so all you have to do if you see someone is just lie them down and start the compressions. And make sure you call 911. Yes, that is going to change things a lot I think because I know the amount of time that you had to do the compressions and then do the mouth to mouth has changed. So mouth to mouth just really isn't used anymore? What is recommended by American Heart is saying that trained healthcare providers who do CPR on a regular basis, they will still do a combination of compressions to ventilations. But anyone else who's not trained to that level that is really important for them just to focus on the circulation and make sure that help is coming. All right, great. So if you wanna know more about the whole heart to, or the, sorry, the hands off CPR, you can go to cpr.heart.org. So why do you guys think this is so important, this change in general? I think the main thing is that it is taking a lot of the fear and a lot of confusion out of what steps need to happen. And it is empowering people to be able to step in and make a difference. You never know who you might be saving by doing CPR on someone. Absolutely. And you? Well, as paramedics in the fire department we're on our way. But you are going to be the first one who's hands on and you are going to be the one that's gonna make the difference. So we are also relying on you as a community to really know that you can put yourself out there and kind of bring everybody back together. Definitely, it is our job. I know a lot of the times people think somebody else will do something. So the bystander effect, people will not want to do anything. But I think since it's so simplified it will definitely help out a lot. Well, thank you so much for being here and letting us know all about this new hands off CPR because I really want this to get out there so everyone knows that they can participate and they can help make a difference. Thanks for having us. Yeah, of course. Thank you so much. If you want to know more about them, once again the website is CPR.heart.org that's going to tell you a little bit more about the hands off CPR. And if you want to know more about Davis Media Access you can go on to DCTV.Davismedia.org or you can find us on YouTube at Davis Media Access. I'm your host Emily Merton and thank you so much for joining me.