By Eric W. Ossmann
The Atlanta Journal-Constitution
Copyright 2006 The Atlanta Journal-Constitution
The Fourth of July is a great holiday in Atlanta; family and friends, picnics, fireworks and the largest 10K road race in the world. As the medical director of Atlanta’s 9-1-1 ambulance provider, Grady Emergency Medical Service, the Fourth also represents the one day out of the year when we stand a good chance of resuscitating a victim of cardiac arrest.
When a person’s heart stops, rescuers only have a few minutes to start CPR before irreversible heart and brain damage begins. After that, the chance for a successful resuscitation declines steeply.
In the city of Atlanta, cardiac arrest is an almost uniformly fatal event. Over the last nine months, fewer than one out of every 100 victims of cardiac arrest has survived to be discharged from the hospital. This gives Atlanta the dubious honor of having one of the lowest cardiac arrest survival rates in the United States.
However, on the Fourth of July, everything is different. Over the last four years, three individuals have suffered cardiac arrest during The Atlanta Journal-Constitution Peachtree Road Race. All survived to be discharged from the hospital. These three went on to resume normal lives, reconnect with loved ones. Some may even run in another Peachtree.
This stark disparity between what we accomplish on the Fourth of July and our dismal batting average every other day of the year comes down to one thing: community commitment.
Saving the life of a cardiac arrest victim is the ultimate medical team sport. Successful resuscitation depends on rapid recognition of cardiac arrest, rapid initiation of CPR by a bystander, early defibrillation and a seamless, integrated emergency medical response system. If even one of the components is missing, it greatly reduces the odds of a successful resuscitation.
During the Peachtree Road Race, Grady Emergency Medical Service implements a robust emergency medical response plan that includes both paramedic ambulances and bike teams strategically placed along the course. Concurrently, the Atlanta Track Club fields a large cadre of medical volunteers for both the course and finish line. Both organizations integrate their communications plans, so runners in distress can be readily identified, and medical help dispatched. In addition, the race is filled with participants who have learned CPR and are willing to stop and render assistance until professional rescuers arrive. The combination of these elements results in an emergency medical response system that is prepared to provide an optimal response to cardiac arrest; victims are quickly recognized, bystander CPR is provided and early defibrillation occurs in the context of an integrated emergency medical response system.
If only things could be this way every day.
Currently, Atlanta is hindered by a fragmented 9-1-1 communications system that adds life-stealing minutes to EMS calls. This problem was first identified by a blue-ribbon mayoral commission in the wake of the Olympic Park bombing of 1996. Ten years later, we’ve made little progress. In contrast to the runners in the Peachtree Road Race, too few of Atlanta’s residents know CPR. At present, only 12 percent of cardiac arrest victims in Atlanta get CPR before firefighters or EMS arrives. We have highly trained and motivated fire and EMS professionals, but they don’t work as well together as they should. These deficiencies must be addressed before we can improve our 1 percent survival rate and approach that of cities such as Seattle, which saves lives at a far higher rate than does Atlanta.
But we don’t have to look to Seattle for inspiration. At Hartsfield-Jackson International Airport, nearly half of all cardiac arrest victims survive. That’s because the airport has good communications, willing bystanders, trained personnel and strategically placed defibrillators, just like the Peachtree Road Race.
Right time — the Fourth of July. Right place — Hartsfield-Jackson International Airport.
Our goal is simple, but challenging. Make the “right time” anytime, and the “right place” anywhere in metro Atlanta and, ultimately, nationwide.
Dr. Eric W. Ossmann is medical director of Grady Emergency Medical Service.