Va. city sets standard for cardiac arrest response
Last year, paramedics jumpstarted 18 hearts, saving 18 lives out of the 32 they attempted to save in Lynchburg
By Amy Trent
The News & Advance
LYNCHBURG, Va. — The chances of surviving an out-of-hospital cardiac arrest in Lynchburg are higher than ever, thanks to local emergency responders.
"Here in Lynchburg right now my numbers are between 54 and 56 percent, said Lynchburg EMS Battalion Chief Heather Childress.
Every year, about 300,000 Americans have an out-of-hospital cardiac arrest, meaning their circulation and hearts stop.
The Centers for Disease Control reports that 92 percent of out-of-hospital cardiac arrest victims die.
But last year, paramedics jumpstarted 18 hearts, saving 18 lives out of the 32 they attempted to save in Lynchburg.
Those numbers put Lynchburg among the best in the country. In Seattle, the rate of Return of Spontaneous Circulation, or ROSC, is 56 percent, said Childress.
Seattle is truly the best, and Lynchburg is right up there with them, she said.
"It kind of rocks to be honest," said Childress. "It's this kind of stuff that makes me proud to work here everyday."
Lynchburg did not previously track ROSC rates though.
Anecdotally, Childress and Jason Campbell, a Lynchburg EMS battalion chief, said the change in the city's resuscitation rate has been significant. Campbell said ROSC was once so rare, that paramedics would celebrate when they were able to resuscitate a patient.
It was "maybe a handful of people a year," said Campbell.
The department began keeping track of very specific performance measures in recent years to show city officials what they are getting for their investment in emergency services.
They quickly learned that technology, advanced training and a medical director with a passion for pre-hospital care have made a significant impact.
If there is good evidence that a new life-saving method works — whether it calls for inducing hypothermia or using more than one defibrillator at a time on a patient — Lynchburg EMS is putting it to the test under the careful eye of Medical Director Dr. Marilyn McLeod, who works for Centra Health and Lynchburg EMS.
As a result, residents are beginning to understand that an ambulance is not just a form of transportation in an emergency.
Emergency responders bring medical care directly to patients and begin life-saving measures on the scene with NASCAR-like precision. What's more, during the six minutes on average it takes them to arrive, an emergency dispatcher leads callers through CPR so not a minute of time is lost.
Cardiopulmonary resuscitation is essential when it comes to saving cardiac arrest victims and preserving brain function. McLeod and the staff currently are trying to find new ways to help inspire bystanders to perform CPR. Chest compressions alone can make a difference, she said.
"Working the patient as soon as EMS gets to them decreases mortality tremendously," said McLeod, also medical director of Centra's transport and helicopter services. Few providers still transport cardiac arrest patients to the hospital for the kind of immediate care that can be done on site, she said.
"There's nothing in the emergency department that paramedics can't do in the field," when it comes to cardiac arrest, she said.
Paramedics have established a strict procedure for cardiac arrest calls, with each responder assigned a specific task. While one must ensure that chest compressions continue uninterrupted at the correct rate, another will be responsible for airway management. That precision, along with the technology on board ambulances, is part of the reason for Lynchburg's success, Campbell said.
Crews have cardiac monitoring capabilities, mechanical chest compression devices and are looking to expand their use of telemedicine — which allows them to provide emergency departments with the graphic details of everything they need in advance. So when crews arrive at the emergency department, the right team of professionals already is assembled.
"It's really amazing the difference we see here now," said McLeod.
The impacts have been dramatic and far reaching. Families now see firsthand how hard technicians work to save lives, and firefighters and paramedics get to see the difference they are making.
Campbell and Childress said people frequently express gratitude for their efforts at the scene.
Paramedics feel like their services are valued now, that they have the respect of physicians, and that they are truly part of patients' overall care, Childress said.
|McClatchy-Tribune News Service|