4 steps to improving your cardiac arrest save rate
Starting a community program can be easier than you think
By Nathan Stanaway
Increasing the health and wellbeing of the community is the goal of every EMS agency. The American Heart Association has recommended that “hands only” CPR be taught to lay rescuers in the hopes of increasing the likelihood of early, life-saving compressions. This means that community members must participate in protecting their own health. EMS can take a lead role in this regard.
Starting a community CPR education campaign is easier than you may think. Here's a case study on how to start one.
Determining the need
In 2010, Greenville County EMS (S.C.) decided they wanted to train their citizens in compression-only CPR. After reviewing their region's statistics, they knew that they could do better; that year, only 5% of cardiac arrest victims in Greenville County survived to hospital discharge with good neurological function.
After taking the first step of collecting data and creating tracking mechanisms, GCEMS took the next step of motivating its EMS providers to provide higher quality cardiac arrest care. Not many things motivate an EMS provider more than seeing the positive results of a job well done. Getting to meet the person whose life you saved and hearing thank-you from them and their family is a wonderful feeling.
Increasing public awareness
A program to recognize and reunite EMS providers with survivors and their families became a priority. Initially, plans had been made for simultaneously launching a public CPR training campaign alongside the inaugural survivor ceremony. Organizers encountered their first hurdle with this plan: they met resistance from some in local government who were concerned about the cost of such a project. The EMS education manager was told to go ahead with plans for the survivor ceremony, but not the public education campaign.
Initially, the event organizers were unsure how successful the ceremony would be. However, reservations for attendees rapidly grew. Initially the ceremony was slated to be held in a small conference room at city hall. Based on the number of reservations they had already received, the event was moved to a room at a local convention center that could accommodate the crowd.
In 2011, the first survivor ceremony was held and was a huge success. Over 300 guests and members of the press attended the event. The success of the ceremony created the needed intra-agency momentum to restart the public CPR training campaign.
Community CPR training organizers again had the green light to proceed. Initially GCEMS received a small state grant and planned to teach traditional CPR classes to members of the community. They soon realized that traditional CPR classes were not very marketable, and it would be difficult to convince citizens to attend. After speaking with AHA representatives about the logistics of a community CPR training campaign, organizers decided to use CPR Anytime kits. These kits were not free, so organizers quickly decided to pursue an additional grant with the help of an AHA representative.
A grant from the Fullerton Foundation allowed the program to purchase the kits, which trainers use to teach compression CPR in about two minutes. Organizers planned to attend local community events, train one or more people, and send them home with a kit to share with others.
Staffing with collaborative partners
The next hurdle was to figure out how to staff the events. The only feasible option was to seek volunteers from within GCEMS. This has been well received by many EMS providers, and volunteers are often given a small gift card as a thank you. Still, continued staffing of events remains a concern, and organizers are always looking for ways to increase available staffing without causing volunteer fatigue.
A recent development is that Greenville Technical College EMS students and faculty are helping with some of the events as part of class projects. This is a mutually beneficial arrangement. Events are a bit easier to staff, and EMS students gain valuable experience interacting with members of the public.
Working toward the greater good
Gaining access to large community events remains a challenge. Frequently, EMS providers experience resistance from major event organizers because the space that would be occupied by CPR training is often valuable space that could house a profitable vendor booth. The solution here is, again, to find a collaborator. For instance, at a recent event GCEMS was denied a request to provide training. However, one of the event sponsors, Greenville Health System, was willing to share their space so that EMS personnel could provide CPR training to event attendees.
Improving the odds
Every event that Greenville County EMS attends results in several hundred people being trained in compression-only CPR. In the past year, approximately 2,000 people have been directly trained to perform CPR. Based on surveys, it’s estimated that for every kit sent home, at least an additional 2.5 people are trained. This brings the total number of people trained to at least 5,000.
There has already been one documented case where a victim of SCA received CPR from a bystander who was directly trained by GCEMS personnel. In a county with a population of about 467,600 people, it's anticipated that 1.36 cardiac arrests annually will be witnessed by one of the 2,000 persons trained at one of the events to date.
The ultimate pyramid scheme
Training someone in CPR is the ultimate pyramid scheme. If one person I trained in CPR spreads that knowledge to their friends and family, eventually, I’ve saved a life. Training people how to react when someone collapses is simple and fast. When groups work together to train large numbers of people in CPR, we all benefit.
Certainly there are hurdles, but none of them are insurmountable. The steps are straightforward:
- Find out how well your service is performing.
- Get buy-in from the people you work with. Find out what motivates them.
- Make plans to train instructors and engage the community through public events.
- Start training bystanders! You don’t have to buy special kits in order to train people. You can use the reusable manikins your service already has.
Every community is different, but each could benefit by engaging citizens to perform life-saving skills when it matters the most. You have the opportunity to help others make the ultimate difference in someone's life. After all, saving lives is why you got into this business, right?
About the author
Nathan Stanaway, NRP, is currently an actively practicing paramedic with Greenville County EMS, South Carolina. He has provided clinical care in several busy hospital systems and EMS agencies for more than 10 years, and teaches in both the classroom and the field. He has participated in several research studies and was a key player in helping to craft and implement a therapeutic hypothermia protocol for an agency in the greater Atlanta area. One of Nathan's greatest passions is improving the EMS profession by promoting education, engagement, public relations, and strong positive leadership.