Mother and teacher Kathie Harden has tears in her eyes when she describes the day one year ago that she "died."

She was asleep in bed when her husband, a sheriff's deputy, noticed that she suddenly had stopped breathing and turned purple. Her heart had stopped.

Scott Harden called for help, and a dispatcher talked him through how to do chest compressions on his wife until an ambulance arrived 12 minutes later.

Without Scott's help, it's unlikely paramedics would have been able to resuscitate Kathie. Odds are, as she puts it, her children would not have had a mom anymore.

But Kathie's story is unusual, in that someone she knew was there, and he jumped in to resuscitate her.

The Flagstaff area ranks last statewide in bystanders performing cardiopulmonary resuscitation on people whose hearts have stopped — which is one of the four least survivable calls paramedics respond to here, they say.

And while national and global data on the subject is incomplete or unreported in lots of locations, people in New York, Detroit, Singapore or Japan are all statistically more likely to help a stranger having a heart attack than people living in or near Flagstaff.

Put another way: If your relative or friend collapses due to heart failure while grocery shopping, there's an 85 percent chance strangers nearby will call 911, but won't immediately start the chest compressions most crucial in saving his or her life.

"We have a horrible bystander CPR rate," said Pete Walka, battalion chief of Guardian Medical Transport.

To have the best odds of surviving, the 60 patients per year in the region who have heart attacks or cardiac arrest need fast, continuous chest compressions in the minutes after their hearts have stopped.

For every minute someone's heart is stopped with no help, his or her odds of survival decrease 10 percent.

NO MORE MOUTH-TO-MOUTH

The old version of CPR required mouth-to-mouth breathing, and that was one significant roadblock, said Guardian emergency medical technician Stephanie Carl.

She has heard concerns from bystanders like "I don't want to hurt them" or "I don't want to put my mouth on their mouth."

"And so," she said, "they end up doing nothing."

This was part of a national trend that began in the 1970s, said Guardian Director Mark Venuti. It comes out of bystanders' concern of catching communicable diseases from doing mouth-to-mouth, or being sued for accidentally hurting someone they were trying to help.

But times are changing.

Now it takes 5 minutes to learn life-saving chest compressions, instead of a 4-hour CPR class, and mouth-to-mouth is no longer required.

And the chest compressions ("hands-only CPR") are highly effective, increasing resuscitation and survival rates to more than half for patients having some types of cardiac arrest.

HEART ATTACKS WITHOUT WARNING

Guardian is making a big push to train more people in how to do "hands-only" CPR.

Sometimes they park outside a restaurant and train anyone in the parking lot. This year they did demonstrations at the county fair, and have trained an estimated 2,500 at this point, said Ray Fitzgerald, a captain and paramedic.

There's even an application for mobile phones that gives directions.

Kathie Harden is teaching the third grade and raising her kids. She was at a recent training on the new, easier version of CPR at the fire station in Bellemont.

It turns out that she had a flu-like virus for a year with few or no symptoms, and it was attacking and weakening the upper left chamber of her heart, she said.

The other parts of her heart compensated as long as they could.

Some of her neighbors turned out at the recent training at the Bellemont fire station.

One was Dan Sallaway, a father who lives near the Deer Farm, volunteers at the fire station and works for Golden Eagle Distributors.

He's helped people out on following the road, including staying with one man whose vehicle had flipped on Lake Mary Road three years ago.

"That's why I was interested in coming down and learning," he said, "because I have three children myself."

Cyndy Cole can be reached at 913-8607 or at ccole@azdailysun.com.

More information

To inquire about training, Guardian is at 213-6277. For more information or videos, see handsonlycpr.org.

Hands-only lifesaving

If you witness an adult collapse:

— Shake the person. If the person is unresponsive and not breathing, or breathing abnormally, call 911.

— Lay the patient on the floor. Place the heel of one hand on the center of the chest and the heel of the other hand on top of the first. Lock your elbows, place your shoulders vertically above your hands and use the weight of your upper body to "fall" downward, compressing the chest 2 inches deep. Lift your hands slightly each time to allow the chest to recoil.

Compress chest at a rate of about one hundred per minute (slightly faster than one compression per second, or in time with the beat of the song "Stayin' Alive"). When you tire, take turns with others until paramedics arrive.

— Continue chest compressions even if patient gasps.

— For cases of near drowning, drug overdose or unresponsiveness in young children (age 1 to age 8), follow conventional CPR (2 mouth-to-mouth ventilations followed by 30 chest compressions). However, even in those cases, compression-only CPR is better than doing nothing.

Source: Arizona Department of Health Services, other agencies