Fla. county sees increase in cardiac arrest survival as more civilians learn CPR
County officials also credited enhanced first responder training, automated CPR devices and AED availability with the increased survival rates
The Palm Beach Post, Fla.
PALM BEACH COUNTY, Fla. — Andy Taylor, 43, says he would not be here today if it were not for a CPR course his then 14-year-old son, Caleb, took at Loggers' Run Middle School in Boca Raton. Taylor returned home from a morning workout on July 27, 2018. He began having chest pains and collapsed. His wife called 911. That is when Caleb, his 14-year-old son, stepped in.
"I got it, mom," he told his mother. Caleb quickly performed CPR, putting to use what he had learned from the full-day course.
"He gave up a Saturday, and it saved my life," Andy Taylor said. "He kept me going until Fire Rescue arrived. Caleb is a hero."
Taylor had 100% blockage in an artery. He was in the hospital for 27 days, and on life support for six of those days. Taylor has fully recovered and returned to work. He attributed his recovery to advanced training of the Rescue crews and collaborative work between them and JFK Hospital. Caleb received a Golden Heart award for "extraordinary bravery" from Fire Rescue for the part he played in keeping his father alive.
Andy Taylor's life-saving moment is an example of why Palm Beach County cardiac arrest victims stand a better chance of surviving than they have in the past. It can be attributed to better training, more defibrillators and increasing use of CPR by bystanders like Caleb.
In 2019, Palm Beach County Fire Rescue had a Return of Spontaneous Circulation (ROSC) rate of 34%. That means that roughly a third of patients with no pulse had their pulses returned. It is not known how many actually survived but the longer there is no pulse, the greater likelihood of permanent damage or death. The county's ROSC rate of 34% is much higher than the state's 20% rate. Before 2015, the county's ROSC rate was about half of what it is today.
County officials say there is better collaboration with hospitals, rescue crews have received enhanced training, more sophisticated equipment is being used such as a Lucas 2 chest compression device that performs 100 compressions per minute and more people are becoming certified in CPR, which is now part of the curriculum in Palm Beach County schools.
A key to saving lives is starting CPR before rescue crews arrive. Rescue Chief Charlie Coyle noted: "It all begins with 911 dispatchers. They ask whether the patient is awake and whether the patient is breathing."
If the answer to both questions is no, the dispatcher instructs the person who called to perform CPR. In 2018, it took an average of 3:06 to "get hands on the chest." Last year, the figure improved to 1:51.
Coyle noted it is critical to get hands on the chest as soon as possible. Rescue crews can take four to six minutes or more to respond. That is too long for someone to go without a pulse. All public places must have Automated External Defibrillators (AEDs) that shock the heart back into a rhythm. Many residential developments in Palm Beach County also have them. Their increased presence is a positive development, according to Coyle.
The family of Jarret Berman believes he would be alive today if Dakota Homes had an AED. Last June, he was playing basketball at the clubhouse of the west of Delray Beach development when he went into cardiac arrest. In a wrongful death lawsuit filed against the homeowners association and GL Homes, the builder of Dakota Homes, Berman's estate claims the development should have had life-saving equipment on site. It took 13 minutes for a rescue crew to arrive which was too late to help Berman, according to the lawsuit. Distances between fire rescue stations and developments in the western end of the county is an issue that the county is trying to address by building more stations.
Fire Rescue has adopted to improve performance, it relies on a "pit crew" concept with each person assigned specific responsibilities. One member, for example, checks for a pulse and begins compressions if necessary. Another checks for blood pressure. And yet another will take an EKG and forward results to the hospital.
Coyle said an eight-month trial study was conducted in 2018 at Battalion 10 in central Palm Beach County to determine how many cardiac arrest victims walked away neurologically intact after certain measures were implemented. The ROSC rate rose to 56% and the neurologically intact rate was 12.5%.
Dr. Kenneth Scheppke, medical director for Fire Rescue, worked with the Palm Beach County school district to develop a CPR training program. Having thousands of students learn CPR has saved lives and helped improve ROSC rates, he noted. Scheppke said Palm Beach County may be the only county in the state where CPR is part of the school curriculum.
Anais Almonte, a senior at John I. Leonard High School, was at a grocery store when she saw a baby choking. The mother did not know what to do. Anais performed back compressions, resulting in the baby regaining consciousness. Two other students have also come to the aid of people in distress through administering CPR.
At JFK, cardiac survivor reunions are held every year. Such events were unheard of five years ago. Survivors meet with Fire Rescue crews and doctors who brought them back to life. Taylor went to one last year. The third annual one was held on Feb. 4, 2020. It was very much personal for Chase Dopson. A fire rescue employee himself, he attended it as a survivor. Dopson went into cardiac arrest on Oct. 9 around 4 a.m. His pregnant wife, Cori, called 911. She did not know how to do CPR. The dispatcher talked her through it, saving Dopson's life. Lieutenant Brandon Bechler arrived at his home to treat him. Dopson and Bechler often work together reviving cardiac arrest patients.
"No amount of training can prepare you for this," said Bechler at the JFK reunion on Feb. 4. Bechler and Dopson embraced each other after Dr. Waqas Ghumman, the emcee for the event, recounted the story. Ghumman is a cardiologist at JFK. He went on to say that the county has a state-of-the art EMS system that is second to none. Nationally, he noted about 10% of cardiac arrest patients who make it to a hospital survive. In Palm Beach County, the figure is 60%, according to Ghumman.
"If you are going to have a cardiac arrest, you are better off having it in Palm Beach County."
©2020 The Palm Beach Post (West Palm Beach, Fla.)