EMS crews saving cardiac patients
Responders focus on teamwork
FAYETTEVILLE — When hearts stop in Washington County, emergency responders are ready with a plan, Central EMS Chief Becky Stewart said.
“It’s the simplest thing we can do,” Stewart said. “It doesn’t cost any money — it’s just focusing on teamwork. It’s just like a pit crew — everybody has a job, and it gets done.”
Emergency workers from multiple departments are working together on a new initiative focused on starting and keeping compressions going and getting patients to hospitals with pulses, officials said.
The effort could save more lives, Stewart said.
Nationally, emergency responders attend to 350,000 cardiac arrest patients outside of hospitals yearly, according to the American Heart Association. Central EMS emergency workers were called to 93 cardiac arrest emergencies last year.
Cardiac arrest is when a person’s heart stops functioning and may not be related to the blockage of blood to the heart, which is called
a “heart attack,” according to the association’s website.
The national survival rate was about 12 percent last year, according to the association’s statistics for cardiac arrests outside of a hospital. The rate is linked to whether a patient’s blood is still circulating when he arrives at the hospital, officials said.
Getting blood circulating gives emergency workers or hospital staff more time to find the underlying cause of the cardiac arrest and fix it, said Tammy East, quality improvement coordinator for Central EMS.
About a year ago, nearly 33 percent of cardiac arrest patients had a pulse when Central EMS delivered them to Washington Regional Medical Center, according to Central EMS figures.
The percentage jumped to 60 percent in January when Central EMS and other emergency officials began a coordinated effort called “pit crew,” Stewart said.
Stewart said the actions and teamwork are reminiscent of race car maintenance teams.
Each emergency worker, including firefighters, plays a specific role and takes turns in resuscitation, officials said. Each has an assignment — like compressions, answering the radio or treating the patient’s airway, said Mauro Campos, Fayetteville Fire Department spokesman. The assignments rotate every 5 minutes, he said.
Campos is the battalion chief over the training division at the fire department. Firefighters are trained paramedics or emergency medical technicians and work with Central EMS.
The pit crew idea came from a new Clinical Task Force Committee created about eight months ago, Stewart and East said. The committee includes representatives from Central EMS, emergency departments, dispatchers, Washington Regional and air evacuation, she said.
The hospital is working with Central EMS to improve the care of cardiac arrest patients, said Danita Mullins, emergency services director, in an email. No further comment was available from the hospital.
Central EMS Capt. Star Butler said fire departments and Central EMS coordinate efforts. That includes training together, Campos said.
The key is to focus on immediate and uninterrupted cardiopulmonary resuscitation and medical care, Butler said.
“It’s just trying to be more efficient, more professional [and] being more cognizant of spending more focus on the quality of the CPR,” Butler said. “That includes trying not to have any interruptions.”
That includes staying longer on scene, Stewart said. It can take up to 40 minutes to restore circulation and be able to move the person, East said. Compressions are not as effective inside the ambulance, Campos said.
Working longer on patients at the scene could worry family members, but the method works, Butler said.
It means compressions are not interrupted — not to check pulse, not to load the person into the ambulance, not during the drive to a hospital, East and Butler said. The important thing is to get the blood flowing, Butler said.
“TV tells us that we need to go to the hospital, but to get the patient to the hospital the patient needs to have that heart rate and that pulse,” she said. “For us, the ultimate goal is to get a heartbeat, a pulse.”
The trend among emergency responders nationally is to get the heart active again before taking a person to the hospital, Campos said. Cammie Marti, director of Quality and Systems Improvement at the American Heart Association, said emergency workers also must work fast to get patients to a hospital.
Local emergency service agencies are doing a “phenomenal job,” especially with patients having deadly heart attacks, Marti said.
Several studies have shown a significant increase