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Insights from Survivors and Rescuers

Insights from Survivors and Rescuers

June 22, 2020 | Last Updated: July 16, 2021

Dr. Dainty wants to bring real experiences to CPR training and AED design

Dr. Katie Dainty does not think that CPR training should just happen in a comfortable, air-conditioned room with a mannequin flat on the floor. Rather, she suggests that we make CPR training realistic. What if someone is sitting in a chair, what if they are foaming at the mouth, what if they are stuck in the car? Dr. Dainty does not shy away from these questions because her research shows that they are critical for improving CPR and AED machine training. As a resuscitation scientist, she has spoken with countless cardiac arrest survivors and rescuers. By listening to their experiences, Dr. Dainty says that we can better understand layperson response and improve education and survival.

Watch Dr. Dainty discuss these ideas and more at the Cardiac Arrest Survival Summit! 



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Dr. Dainty (00:00):

So my name is Katie Dainty and I’m a PhD social scientist. I work at the University of Toronto in Toronto, Canada. So I have two areas of research that I work on. I work on survivorship, so the journey that patients have after they leave the hospital and return to their families. I also am very interested in bystander experience. So the majority of my work is in interviewing and trying to give a voice to what it’s like to be a bystander, mostly lay responders. We like to use the term lay responder because bystanders standby, and responders react. And so I’m very interested in how we can learn from their experience and improve our response systems based on their experience. 

Dr. Dainty (00:53):

Quite honestly, a lot of them have a very bad experience for a little while because while some are empowered, many end up with a sort of a post-traumatic kind of effect because they’ve just seen someone collapsed. They’ve been called to action. They may or may not be trained, but they know they have to do something. And then the ambulance comes and takes away the patient or the victim and the bystander is left there standing there, not knowing what just happened, what they’re supposed to do next. And many of them have sort of some sequelae that happens afterwards that we’ve never, ever paid attention to. We’ve spent so much time getting people to do layperson CPR and training them in these, quite frankly, terrible environments of air conditioned rooms where the mannequins are flat on the floor. 

Dr. Dainty (01:44):

And sometimes there’s an AED there. Sometimes there isn’t and the mannequin doesn’t smell or isn’t vomiting or isn’t between the wall and the toilet. And it’s so unrealistic that when it comes to actually having to respond, it’s not nothing the same. So their experience is actually not ideal. Yeah, I mean, I think we have to empower lay responders. We have to make it a social responsibility. I think we should talk more about making it a social movement. Something that we do for each other as human beings. In some ways people are more likely to pull out their cell phone and videotape someone collapsed on the floor than they are to get down and do CPR and we have to change that mentality. So I think that starts in the training environment. I also think making it a bit more realistic, especially some of the work that’s being done around women, female mannequins, and things like that. 

Dr. Dainty (02:36):

Gender differences and race differences. Also put the mannequin in a chair and ask, what do you do then? You know, you have to get them down on the floor and know what that feels like, that they’re foaming at the mouth or they’re blue or whatever the situation might be. I think making training more realistic, and more training on the AED and what that looks like. Many AED companies claim that it’s easy to use, but some of the work that some of my colleagues have done actually interviewing lay responders shows that 60% of time the AED fails in some way that we don’t expect. Responders don’t know what to do with that. So whether that be that the pads don’t stick or the lead falls off or the thing doesn’t start or whatever it might be. 

Dr. Dainty (03:27):

We have real issues there that we’re not paying attention to. I think we could do a better job of letting people know what an AED is about, that it is a shock, but that it is a good thing. Some responders are reluctant to electrocute somebody, you know, that’s, I’ve heard that before. So I think we could do a lot more to make the training more realistic, not to scare people away from doing it, but to empower them so that when they do it, there’s muscle memory, there’s psychologic memory and they can do it just very simply and easily. When the time comes, I think it’s grassroots. We’ve been doing some work with some smaller communities in Ontario, Canada just because the community piece is already a bit stronger sometimes than in large cities, but I think it starts at a grassroots level. And so we work with our heart and stroke foundation in Canada to look at training and how we can change that to be more realistic, more practical and really talking about these kinds of things as part of training that you will meet. You might have trouble sleeping because you might have flashes of what you just experienced and things like that. Letting people know that that might be coming. So we’ve done a little bit of work in that way, but we’re just getting started. 

Dr. Dainty (04:47):

The possibility of changing training to be more empowering and learning from actual lay responder experience to inform what we do. I think that’s got so much potential. Instead of just everybody sitting in a boardroom, a bunch of physicians sitting in a boardroom deciding how training should be designed. Our content experts are not, the resuscitation scientists, to be perfectly honest. Our content experts are people who have been in that situation before. And in particular, those who have been in that situation with a loved one. Being asked to do CPR on your husband is a very different experience. And so that again is another piece where we can really be paying attention to those who have experienced it and learn from them and make the training more realistic in that way. So that’s where I think that’s big, I think that’s where we’re going. 

Dr. Dainty (05:38):

I think we have to do that. Can I keep doing more of the same? I think it was Einstein that said, repeating the same thing over and over and expecting a different result is the definition of insanity. And we’re in full insanity right now because we just keep doing the same thing over and over and expecting survival rates to change or bystander CPR rates to change and they’re not going to. I do think accessibility is something that we should address. Some of my colleagues in Toronto, some of my engineering colleagues have done some work around modeling that with Tim Horton’s or Starbucks coffee shops, a bank, machines, places where people actually go on a regular basis is where we should be putting these behind the glass. Boxes in the condo security office is not the place where an AED should be. 

Dr. Dainty (06:24):

Definitely making them more accessible, looking at them through the lay person’s eyes. There has been some work around the fact that even using the lightning bolt symbol, that is also the symbol for electrocution and that scares people off. The fact that, here in North America, we use red as the sort of color for AEDs and for emergency response, which typically means stop. In other countries they use green. In Japan they use green on the AEDs because that is an encouraging color. So there’s, there’s human psychology and human behavior I think that we could incorporate into the AED space that I think could be really good. Improving accessibility around cost for sure. But also just what they look like, how they’re used. Making people more aware of them, I think would be, would be really exciting. We have to think about it more through the eyes of the lay responder and whether that be a family member or a stranger. What does that look like and how do we maximize that to be able to design a system that works really well all of the time. Make it more cool to do CPR.