IBX: The Cover Story – Teamwork Saves a Life With CPR

Peter Panageas (00:07):

If you’re looking for timely, relevant conversations about the most important topics in health coverage, you’ve come to the right pod. This is IBX: The Cover Story from Independence Blue Cross hosted by me, Peter Panageas. So by day, I oversee all of our national commercial business here at IBX. I’m also a caregiver and a patient. We always say that healthcare is personal, and it is. So my guests and I are exploring how the big picture and the big issues affect our everyday lives and the wellbeing of those we all care about. Together, we’ve got this covered. So let’s get started.

(00:45):

Hi, everybody. This is Peter Panageas, and welcome to episode 15 of IBX: The Cover Story. For this month’s episode, you’re about to hear an incredible and amazing story about a brave woman in Karen Silverio, who’s a personal friend of me and my wife. Karen’s husband Joe is a lifelong friend of mine. For our audience, Karen is healthy, active, eats right, exercises, doesn’t smoke, and the story you’re about to hear of how she overcame her cardiac arrest is an amazing one. You’re going to hear about how an up-and-coming medical student by the name of Krzysztof Zembrzuski  worked with a police officer to help administer CPR on Karen. And you’re also going to hear from Karen’s ongoing cardiologist, Dr. Reginald Ho of Thomas Jefferson University Hospital.

(01:32):

Every 40 seconds, someone in the United States has a heart attack, and over 400,000 Americans die from cardiac arrest each year. If performed immediately, CPR can double or triple the chance of survival. But unfortunately, only about 40% of people who’ve gone into cardiac arrest have immediate help. So Karen, Krzysztof and Dr. Ho, on behalf of Independence, thank you all so much for being with us today.

Krzysztof Zembrzuski  (01:57):

Thank you for having us.

Karen Silverio (01:58):

Good to be here.

Dr. Reginald Ho (01:59):

Thank you so much. Glad to be here.

Peter Panageas (02:00):

Excellent, excellent. So Karen, this is a real personal thing for me. Take us through the day that you went into cardiac arrest from your own perspective.

Karen Silverio (02:10):

I will. So it was a normal morning back in January of this year. I got up. I took my daughter Gianna to school. I drove her to high school that morning, came home. I was getting ready for work. I left the house around 7:45 in the morning, said goodbye to my husband Joe, typical stop at Wawa for a cup of coffee. And I was on my way to work at Rowan Medical Osteopathic Medicine Center, where I am a standardized patient there. So I was pretending that day that I had OB-GYN encounters.

(02:52):

So I ended up pulling into the parking lot early. I was texting back and forth with my girlfriend, Michelle, because she was having nose surgery that morning so I wanted to wish her well. And then I must have gotten out of the car, and that’s when I went over and just collapsed, I guess. I really don’t remember a whole lot except for what people have told me since that episode. And then I met my savior, Krzysztof.

Peter Panageas (03:23):

Krzysztof, as we were preparing for this podcast, you gave us a lot of insight not only from a personal perspective, but also in your journey as a professional perspective. And at this point in your journey, give us your perspective. As the person who saved Karen’s life, take us through the day of the events that happened.

Krzysztof Zembrzuski  (03:41):

Yeah, sure. So it was just another day. I was heading over to school and I was pulling into the parking lot. And as I was going through the parking lot and driving, I see out of the corner of my eye that there’s an individual on the ground. And there’s a police officer attending, and it looked like they might’ve been giving CPR, but it looked like something just happened.

(04:01):

So right away, I just pulled in my vehicle. Being that I’m a medical student now, I’ve had some training with these situations and I decided to get involved and just ask right away if anyone needs help. But in these scenarios, it’s different when you’re in a hospital versus when you’re out in a parking lot. I realized anyone needs help in this situation. So right away, I just asked how long Karen was on the ground for. And it seemed about a minute or two, and I just swapped out the officer and just did compressions. Yeah, there’s a lot going on in the situation, but all I know is that there is a woman here and she doesn’t have a pulse. So I’m just going to do what I can and give as many compressions as I can. And I guess each 30 seconds, you don’t know what’s going to happen.

(04:48):

During this time, the police officer was able to grab the defibrillator, and we worked as a team to basically help resuscitate Karen. It was the first time I’ve ever been in a situation in a parking lot, and I guess there’s a lot of thoughts going through my head. Karen was having agonal breaths, so it seems like at times we were able to… It seemed like everything was going well, but the reality was it wasn’t. But the only thing I could tell you from my perspective, I just kept doing compressions. I just kept going and going and hoping that paramedics would arrive soon. But it was definitely a scary scene. I couldn’t tell you how much time went by. It seemed like over 10 minutes from the time Karen originally collapsed. So yeah, it was a scary scene and it didn’t seem like everything was going to turn out for the best.

Peter Panageas (05:33):

Krzysztof, you administered for about over 10 minutes.

Krzysztof Zembrzuski  (05:36):

So I don’t… Not 10 for me. This is also including by the time I think paramedics just arrived. From my end point, it was so much going on. And anyone that’s been in a situation like this knows that time is warped. I must have done myself five, six rounds. Stop, check, breathing, do what you can. I just tried to open up her airway and see… And the agonal breaths came on at a coincidental time, but I couldn’t tell you exactly… But by the time paramedics came, it was a while. All I know is I was really late to my classes and there must have been… Some time definitely went by.

Peter Panageas (06:17):

Krzysztof, let me ask you this. Tell our audience where are you in your journey in med school.

Krzysztof Zembrzuski  (06:23):

So currently, I’m third year medical student at Rowan School of Osteopathic Medicine, now also known as Virtua Health College. But I guess I’m a fourth year now as of last Friday.

Peter Panageas (06:35):

Congrats.

Krzysztof Zembrzuski  (06:36):

Thank you. Yeah, so right now I’ve finished up my core rotations and I will be starting my board examinations these next few months and my audition rotations, and I’ll be applying for residency. So I’m towards the end, and then the next step is residency. So it’s a long journey, absolutely, but I’m happy to almost be done with the school component.

Karen Silverio (06:59):

Yay.

Peter Panageas (06:59):

Let me shift over to Dr. Ho. Doctor, first of all, I’d love to get your perspective on what Krzysztof did to save Karen’s life. And also, can you share with our audience how does this happen to somebody like Karen? I mean, look. I personally know Karen, right? As we were prepping, Karen is best friends with my wife. Her husband and I are dear, dear friends, we’ve grown up together. I know Karen on a personal level. She eats well. She exercises. She does yoga. She’s an amazing, amazing spiritual person full of positive energy and love, and this happens. So love to get your perspective of how does this happen? How does this trigger on somebody like Karen?

Dr. Reginald Ho (07:41):

The issue of sudden cardiac death is a major problem. As you know, in the United States, 400,000 people each year die from sudden death. And sometimes, we have an idea of who are at risk for it. The people who have heart problems, poor we call LV function. Other people, their heart function may be normal. And then there are patients who are in between who have heart problems where we don’t know whether or not how much at risk they are. And so trying to risk stratify different individuals with different heart problems can be very challenging. And that’s our goal in cardiology, is to try to identify who are going to be at risk, who should get a defibrillator, who should not get a defibrillator. These are the challenges that we have that we face each day.

Peter Panageas (08:29):

So Dr. Ho, if I came to see you, what would be a symptom that I would have that you would diagnose whether I should have a defibrillate or not? Can you give our audience an insight as to what would be a symptom and/or what would be a diagnosis from your lens?

Dr. Reginald Ho (08:46):

Absolutely. So some of the things that could herald sudden cardiac death is if someone has what we call a syncopal episode. So they pass out transiently and then regain spontaneous consciousness. So syncope could be a marker or a red flag that something imminent is about to happen. But any other cardiovascular symptoms that are concerning, that are unusual for patients, so if they have chest pain, shortness of breath, things that are out of the ordinary should always be evaluated in the context they undergo evaluation to see what the cause of their symptoms are and what needs to be done about it.

Peter Panageas (09:26):

Love to also get your perspective on this young man, who is a miracle here for Karen. I’d love to get your perspective, as an up-and-coming physician, what Krzysztof did and how he reacted. Just love to get your perspective as somebody who’s been in the field for a long time. And when you hear this story and how he just jumped into action, love to get your perspective on what Krzysztof did.

Dr. Reginald Ho (09:46):

Absolutely. I think that Krzysztof, you did an absolutely marvelous, wonderful job. You saved Karen’s life. There’s a lot of people out there who could have just moved on. They saw that the police was there and everything was taken care of, but you took the initiative to go and help out.

(10:02):

And as you mentioned, medicine is a team effort, and one policeman would not be able to do it alone. And by you substituting and doing CPR for him allowed him to get secondary help, call EMS, get the AED which is vital for her. And I just commend you for not only your ability to do CPR, but your initiative to go and help someone who is in need.

Krzysztof Zembrzuski  (10:27):

Thank you, Dr. Ho. That means a lot.

Peter Panageas (10:29):

So Karen, look. I remember getting the call from Joe the night it happened. And we all came over to the hospital, and we were collectively all praying for you. Give us your perspective. How has this incident changed your life and the life of your loved ones? I mean, I know it from a personal perspective, but I’d love to have the audience hear your story there.

Karen Silverio (10:50):

Oh, my story, because I don’t remember anything, I feel bad for everybody that had to be there and to see me that way. I mean, I was in a coma for a day and a half. And my brother came up from Georgia. And when he arrived at the hospital, he said they didn’t know if I was brain dead or what I was. And my brother, Dennis, ended up saying to me, “Oh, I like your white nail polish,” and I happened to look at it. So they knew that something was going on in a right direction. You just really cherish every day. And I think it affected everybody that was involved with the whole situation. But you do, and you just look at people now. Just be kind. But it definitely affected everybody.

(11:39):

And for all of my family and friends, it’s always a big party when we get together. I know at the ICU, I heard, and again I don’t know this, but I heard that the nurses said how loud my family was in the ICU [inaudible 00:11:54]. I think it was Pete that did that.

(11:58):

But now, everybody wants to do training for CPR. So they said to me, the organizer, “Karen, get a party together. Let’s bring somebody in, and we’ll all learn how to CPR. Because obviously, if Krzysztof can save your life, we can also save it for somebody else.” So it’s changed it. It has. But on some avenues for myself, on some levels I haven’t really been affected by it because I don’t really know.

Peter Panageas (12:26):

Well, the impact you’re making in making sure that we all are going to be CPR certified is something that I think did come out from a very positive perspective. And Krzysztof and Dr. Ho, I’d love to get both of your perspectives. Talk to our listeners about your respective CPR training that you’ve received, what it’s meant to you. I mean obviously, Krzysztof, it’s a game-changer for you in your journey, right, and how you’ve applied what you’ve learned to this. And love to get your perspective, Dr. Ho, your perspective on CPR training and what avenues that are out there for maybe just the general public to go through. So maybe Krzysztof, I’ll start with you.

Krzysztof Zembrzuski  (13:02):

Oh yeah, absolutely. So my training, I got the basic life BLS training. I did this with my school. From my standpoint, when you get this training, you never really think you’re going to use it, honestly. It seems like it’s something that’s just… You do it for certification, and maybe one day something will happen. And like Dr. Ho mentioned, 400,000 people experienced sudden cardiac death. So I guess the older you get, the more things happen in life, and these situations actually happen.

(13:32):

What it did for me, I think as a student, I mean I’m mainly just taking tests and I’m studying. I’m in the hospital as well, but this was, I guess, an opportunity to really get involved and really help someone. This journey is so long. You have to wait a while before you could really make an impact on someone. And for me and my journey, it reinstilled everything I stand for and why I do this, why I signed up for this. It’s wanting to help others. To be able to serve someone in situations where you can feel hopeless, I think that’s everything. That’s the gift that keeps on giving.

(14:05):

You want to help others, and it’s really that critical time when you don’t know what to do. You could just fall back on the training that you have. You don’t have time to think, and you could just simply administer CPR. It really is just give compressions. That’s really all you can do. And then hopefully, you get more help after 10 minutes or so, whatever it is, ambulance comes. But yeah, it really was, I think, a monumental time in my life, and it helped me remember everything that I’m doing and why I’m doing it. And I think it’s going to help me decide what track I go into in medicine, and hope I could be involved in other circumstances where timing and critical decision-making is everything.

Peter Panageas (14:46):

Thank you, Krzysztof. How about you, Dr. Ho?

Dr. Reginald Ho (14:48):

Yes, I’d like to not only mention the importance of CPR, but also make a plug in for knowing how to use and where to find an AED. Those are incredibly important. So CPR is one part of resuscitation. Rapid defibrillation is also another vital part of defibrillation and saving life. And every public venue should have an AED, soccer fields, high schools, middle schools, and knowing where to find it… And the instructions are generally fairly simple, but in the chaos, in the heat of the moment it can be difficult for some people. But trying to get an understanding of AED, how to find it, how to apply it is incredibly important.

Peter Panageas (15:32):

In talking to Karen, Dr. Ho, I asked her, I said, “What is the diagnosis? What was an official name of what happened to you?” And she said, ” Mitral annular disjunction.” Did I say that correctly, Dr. Ho?

Dr. Reginald Ho (15:44):

Yeah, mitral annular disjunction. Yes.

Peter Panageas (15:47):

Can you tell our audience a little bit about what that is? And equally, can you also share with us some of the treatments that you are doing for Karen?

Dr. Reginald Ho (15:57):

Sure. So mitral annular disjunction is a relatively new diagnosis. It’s within the context of what we call malignant mitral valve prolapse syndrome, which is a spectrum that can range from somebody having severe leakiness of the mitral valve to sudden death. And so mitral annular dysfunction is one of the high-risk features of this syndrome that could be associated, or has been associated with, ventricular fibrillation. And sudden death is a altered spatial alignment between the mitral valve and the summit of the left ventricular posterior wall, which you see on Echo and cardiac MRI. And that’s what we found on her cardiac MRI.

Peter Panageas (16:38):

So it’s something that could be, if one of our listeners went in and saw the cardiologist, that could be something that could be picked up on a scan or on an ultrasound.

Dr. Reginald Ho (16:47):

Yes. So echo, or if there’s a reason for getting a CMR MRI, it could be picked up on MRI. The issue is risk stratification. If someone saw it but had no symptoms, risk stratifying that patient is important because putting a defibrillator in everyone, it may not be the best thing . There are risks involved. And so we want to identify who is at risk, where a defibrillator would be important, and we need more studies for that.

Peter Panageas (17:12):

And Karen, I know that Dr. Ho is your attending physician right now. Can you talk? And maybe Dr. Ho, you can share with our audience a little bit about the journey that you and Karen have been on. But Karen, would you share with our audience when you saw Dr. Ho at Jefferson, what was the conversation and what ultimately was the treatment?

Karen Silverio (17:29):

So they went through different treatments or different trying to find why I went down. And eventually, they did an MRI of the heart and they found this mitral annular disjunction. So the treatment was is to put a defibrillator in me. Do I have a pacemaker too?

Dr. Reginald Ho (17:49):

Yeah, you do have a transvenous device. Yeah.

Karen Silverio (17:52):

And Joe and I did meet with Dr. Ho on March 8th as a follow up, and everything went well. Everything really did went well. He did more testing to make sure. And I also have something at my house where if any… It always sends readings to Jefferson to make sure that the defibrillator is working. And also, if I do have any kind of heart arrhythmia or anything like that, that it’s going to show up on this screening that goes to the radiology department over at Jeff, which is very, very cool, all this technology that they have.

Peter Panageas (18:31):

Dr. Ho, if you could share with our audience what the defibrillator does for Karen, right, maybe walk through that. What does it do for her to prevent this from ever happening again?

Dr. Reginald Ho (18:42):

Absolutely. So the defibrillator senses the electrical signals of the heart. And so if it goes into a rapid malignant fast heart rhythm, it’ll charge up its capacitors and then deliver a shock to restore sinus rhythm, much like the automatic external defibrillator did that the police had put on Karen. But that’s an external application. This is all internal, all automatic, so it automatically do it without the need for anyone to help her.

Peter Panageas (19:09):

We talked earlier about symptoms. So if I had to ask you, what conversations should a patient have with their doctor to assess their risk for something like this?

Dr. Reginald Ho (19:20):

Yeah. So it would be symptoms whether, as we had talked about, whether they pass out, syncope, chest pain, shortness of breath. Other things in the history that are important is a family history of young people who are dying. Is there a genetic predisposition to dying suddenly? And of course, structurally what’s going on with the heart? Do they have blockages in the blood vessels? Is their heart muscle weak? So the patient would provide some symptoms as to what’s going on. The physician would do an evaluation to see what kind of risk and what the cause of the symptoms are.

Peter Panageas (19:53):

After this procedure, can one get back to somewhat of a normal life?

Dr. Reginald Ho (19:57):

Yes. So my job is to make it that Karen can go out and enjoy life, spend time with family, go to Delray, go to Florida, do what she wants to do. My job is to worry about her defibrillator, and that’s the reason why we have that remote monitor so I can see what’s going on. So if I see anything abnormal, anything concerning, any red flags, then I could call her and let her know what’s going on, whether she needs to see me or so. So I’ll be following Karen, but I want her to go and enjoy life.

Peter Panageas (20:26):

Well look, Krzysztof and Dr. Ho, I’ll tell you both this. And again, this is a testament to not only the two of you, but certainly to Karen and her spirit. When I look back on this chronology of when I got the call from her husband Joe and my dear, dear friend, I was actually on my way to see a basketball game, the Philadelphia 76ers play. And Joe called me and shared with me in the news, and obviously I immediately ran to the hospital and was there with my wife and certainly Karen’s family and Joe’s family and all collectively praying. From that moment to the point of within 60 days of that, post 60 days, because of the work that you two did and certainly because of Karen’s spirit, Karen I think you were skiing, is that right? Right?

Karen Silverio (21:10):

I went skiing twice.

Peter Panageas (21:12):

Yeah, twice. Go ahead. Tell our audience what you’ve done.

Karen Silverio (21:17):

I went skiing twice. We went to Delray, Florida. We were jet skiing, parasailing. We rented a boat, paddle boarding. But it was really funny because when I went to see Dr. Ho on March 8th, I was like… He was going through everything and he’s like, “You can’t golf until May 1st.” I’m thinking to myself in my head, “How do you even know I’m a golfer?” Somehow he knew, and I was like, “May 1st? Okay. Well, according to April 25th now, so it’s only around the corner.” But I have been able to do everything. And by the gracious of God, really, the good Lord has not ended me with any brain damage, what have you. So I do believe in… I keep going. Thank you, Dr. Ho and Krzysztof, for that.

Peter Panageas (22:11):

Look, I want to shift this to a little bit more of a personal journey because I think it’s a pretty cool journey both for Krzysztof and Dr. Ho. And if we could indulge our audience here, Krzysztof, you and I, when we were talking and getting ready for this podcast, I asked you a little bit about your family. And you come from a family that heals. And tell us a little bit about your family, Krzysztof.

Krzysztof Zembrzuski  (22:31):

Yeah, sure. Medicine definitely runs in my family. My father’s a physician. My older sister is a physician resident. And I have two half-brothers, but they’re both physicians as well. I guess growing up, you really see the sacrifice and dedication and the selflessness, especially with what I saw during COVID, of what physicians really do. I guess it really teaches you that this profession’s not about, let’s say, prestige or whatever, but it really is about the ability to serve others. So I think growing up, that always had a impact of me. I saw the fulfillment it could bring and the purpose it could give you in life.

(23:13):

I was growing up and I was involved. I was a competitive freestyle skier. I was in high-adrenaline sports. I’m also a certified solo sky diver. So I’ve always been in circumstances that are like high adrenaline. So I guess to connect the two, I saw that in these sports, there’s a lot of incidents that don’t go well. People get injuries. People sometimes have fatal injuries. And after having witnessed some, I always wanted to know how I could help, how I could be of service. I think that was always what kept me going. I wanted to learn more.

(23:48):

So as I grew up, went to high school, college, I decided I wanted to take this path as well. And I was also touched with, I guess, experiences in my life that drew me more towards the field of medicine. So I guess it’s not like one thing that makes you go into this field, but there’s a whole series of events. It’s a journey that make you decide to go down this route. And I guess if you compile everything together, that’s how I ended up here.

(24:13):

And then here’s another monumental incident I had in my life that keeps inspiring me to pursue and to help others and to be of use in times where you wish you could help someone. Hopefully, I can. I guess that’s the real goal here. And yeah, it’s just, I guess, a journey. I learned a lot from my family and my life experiences, and now we’re here.

Peter Panageas (24:36):

That’s incredible, Krzysztof. And while I certainly don’t know your family, one thing’s for certain. I know they’re all very, very proud of you for not only who you are, but certainly what you did to save Karen. And you having that surrounding has blessed us all. And not only today, but in certainly going into the future on how you’re going to be able to serve people. It’s an amazing, amazing gift and incredible.

(25:01):

Dr. Ho, how about you? Tell us a little bit about your story. I’d love to hear your story.

Dr. Reginald Ho (25:05):

My story. Grew up in Hawaii, went to school at the University of Notre Dame, went to medical school at University of Pennsylvania. Did my residency there. Did some cardiology fellowship training at the University of California San Francisco and came back to [inaudible 00:25:21] for more training. And then for the last 23 years, I’ve been at Jefferson and enjoyed my time there taking care of wonderful people just like Karen.

Karen Silverio (25:27):

[inaudible 00:25:28].

Peter Panageas (25:29):

Amazing. Dr. Ho, your journey is certainly an incredible one as well. And for our listeners, and Dr. Ho is being somewhat modest, but if you’re familiar with Notre Dame’s 1988 undefeated season, Dr. Ho was the unexpected kicker who helped lead the team to win the college football national championship that particular season. There’s also a 30 for 30 documentary featuring Dr. Ho’s story, which we’re going to post on our show notes. So take a few minutes to watch it. It is an amazing story, and it’s a testament, Dr. Ho, to your commitment to excellence and certainly your passion around being a part of a team sport. And I think you said it earlier, right?

(26:07):

And Krzysztof, the story that you shared with you and the officer saying, “I got this. You go over there and take care of that, and let’s together help somebody,” I think is a testament to what it is to be working in a team environment to save one’s life. And certainly, I think some of the success that you’ve had in the past, Krzysztof, in all the things that you’ve done leading up to this point, and certainly Dr. Ho that you’ve had in your past leading up to this point and been serving the community for the past 20 years, is a great testament to not only your families, but certainly your personal being as well. Amazing.

Dr. Reginald Ho (26:41):

Thank you.

Peter Panageas (26:42):

So Krzysztof, Dr. Ho and Karen, I can’t thank you all enough for this incredible discussion today. It touches on so many elements from a personal perspective to a professional perspective, to a spiritual perspective, and what you’ve all done together to save the life of a beautiful, beautiful person. Sorry. As I do with all of our guests, I ask if there’s any one or two things that you’d like to share with our audience, what would it be? Krzysztof, I’m going to start with you.

Krzysztof Zembrzuski  (27:16):

Yeah, sure. I guess the biggest thing I could say is just don’t be scared. Be brave. Whether it’s incidents like this or anything in life, any of your life goals, just take initiative and do what you think is right even when you don’t think anything’s in your favor. So that’s my advice not just for incidents like this, but anything in life. And then maybe you could help someone’s life at the end of it for all you know.

Peter Panageas (27:43):

Well said, Krzysztof. Dr. Ho?

Dr. Reginald Ho (27:46):

I think that one of the most important things in our times is not to lose touch with humanity, to lose touch with each other. In times of COVID, times of war, there are lot of things going around us that we cannot control, but to never lose sight of who we are, that we care about each other, and that we do our best to help each other in this world.

Peter Panageas (28:08):

And Karen, before I come over to you, I’d be remiss if I didn’t say this to both Dr. Ho and to Krzysztof. Dr. Ho first. We know what you and your colleagues do every day. We know the sacrifice you make. We know the personal commitment you make, and we know how hard and how much of a sacrifice it is to be a physician today whether it’s at Jefferson or any other facility or any provider around the globe. What you all do is absolutely amazing, and we are all eternally grateful to you and your colleagues for all you do. And Krzysztof, for your family, and certainly for you entering this space, knowing the commitment and the sacrifice you’re making now and will continue to make to serve all of us, we are all eternally grateful to you as well and to your family.

Krzysztof Zembrzuski  (28:51):

Thank you.

Peter Panageas (28:52):

You’re welcome. Karen, if there’s any one or two things you want to share with our audience, what would it be?

Karen Silverio (28:58):

Well, I just want to say thank you to Dr. Ho, Krzysztof, Pete, my whole entire family and friends that have been on this journey with me. And you know what? I do have one thing to say. And that’s on the back of my window of my car, I have a bumper sticker that says, “Just be kind.” And that’s a great… That’s all you have to be in life, is just be kind because it does come back to you. Look, from the bottom of my heart, I thank all of you for what you did for me and for my family as well and friends. Because if I wasn’t here today, I don’t know where they would be. But thank you.

Peter Panageas (29:42):

Karen, Krzysztof and Dr. Ho, thank you all so much for joining us today. And to our listeners, as always, thank you and I hope you’ve enjoyed our discussion. Check out the show notes for more information at insights.ibx.com. That’s insights.ibx.com.

(29:57):

Thanks again for joining us. And remember, you never know whose life you can save by simply getting trained in CPR. Thanks again, everybody. Have a great day.