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Wake EMS Blog » CPR Pro

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May 30, 2008

Wake County EMS System -Treatment Guidelines Lead to Four-fold Increase in Survival Rate for Cardiac Arrest

Image

A new study finds that recent guidelines outlined by the American Heart Association (AHA) for treatments used by emergency medical practitioners on cardiac arrest patients has lead to substantial improvements in survival rates. The findings show that, when fully implemented, the treatment protocol increased the odds of survival nearly four-fold for victims of cardiac arrest.

The study, led by Drs. Paul Hinchey, Brent Myers of the Wake County EMS System in Raleigh, N.C., is the first comprehensive evaluation of 2005 American Heart Association guidelines on the use of compression, ventilation and induced hypothermia after community-wide implementation. The results are based on the outcomes of adults treated for cardiac arrest by emergency responders in an urban/suburban emergency medical services system with existing advanced life support.

The authors highlight the benefits a healthcare community being able to implement a comprehensive care plan for victims of cardiac arrest “from the living room of the victim’s home to the intensive care unit (ICU).”

The essential elements of this plan were a focus on simple, continuous cardiac compressions, controlled ventilations, early utilization of induced hypothermia and transport of resuscitated patients to specialized post-resuscitation hospitals.

Image

There is ample evidence to support the use of continuous compressions and induced hypothermia. However, unlike previous studies that demonstrate the effectiveness of individual interventions on a study population, this study demonstrates the substantial impact that comprehensive implementation of a multi-disciplinary treatment protocol can have on a community.

“Our findings not only demonstrate beneficial outcomes for victims of cardiac arrest, but also suggest the possibility that such treatment plans can be implemented for other medical conditions,” say the authors.
The presentation is entitled “Out-of-Hospital Cardiac Arrest Survival after the Sequential Implementation of 2005 AHA Guidelines for Compressions, Ventilations, and Induced Hypothermia”

This paper was presented at the 2008 SAEM Annual Meeting, May 29-June 1, 2008, Washington, D.C. Additional information is available at: www.wakeems.com/saem

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SAEM: AHA Guidelines for Cardiac Arrest Treatment Increase Survival

Medical News: Emergency Medicine

SAEM: AHA Guidelines for Cardiac Arrest Treatment Increase Survival
By Todd Neale, Staff Writer, MedPage Today
Published: May 30, 2008
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco

WASHINGTON, May 30 — The rate of resuscitation after out-of-hospital cardiac arrests jumped nearly four-fold when new guidelines on CPR were fully implemented in a
North Carolina county, according to cpr picresearchers here.

The 2005 American Heart Association guidelines outlined a protocol calling for simple, continuous chest compressions, controlled ventilation, and early use of induced hypothermia.

When the guidelines were fully implemented in Wake County, which has urban and suburban areas and a population of about 815,000, cardiac arrest survival increased 3.99-fold (95% CI 2.19 to 7.27), Brent Myers, M.D., M.P.H., medical director of the Emergency Medical Services System in Raleigh, N.C., reported at the Society for Academic Emergency Medicine meeting here.

Overall survival increased from 2.4% using older guidelines to 6.7% after introduction of the full 2005 AHA protocol. He said that “the neurologic improvement was at least as robust as the survival improvement.” The entire protocol was introduced for less than $200 per patient, he said. “All of these changes are simple, they are inexpensive, and they are incredibly effective,” he said.

CLINK HERE FOR COMPLETE STORY

Source reference:
Hinchey P, et al “Out-of-hospital cardiac arrest survival after the sequential implementation of 2005 AHA guidelines for compressions, ventilations, and induced hypothermia” SAEM Meeting 2008; Abstract 167.

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April 5, 2007

Cardiac ‘Saves’ Hit All-Time High; Wake’s Rate in Top 3 Nationally

One out of every three — 34% — of the people who suffered treatable cardiac arrest in Wake County in 2006 survived to return home from the hospital, up from 19% in 2004 and 28% in 2005, according to Wake County EMS system data.

CPR

Based on the latest national data, that places Wake County among the “top 3″ service areas in the United States for recovery from “survivable” cardiac arrests. Nationally, the average survival rate is 17%.

“No one wants to have a heart attack anywhere, anytime, but because Wake County’s paramedics, firefighters, emergency medical dispatchers and receiving hospitals are better prepared than most to deal with cardiac arrest, victims have a higher probability of successful resuscitation in Wake County than most places in the U.S.,” said Dr. Brent Myers, medical director of the Wake County EMS System.

Wake County paramedics and firefighter “first responders” evaluate heart rhythms in people suffering cardiac arrest, a condition in which heartbeat and breathing stop. Of the 450 full-arrest cases in Wake County last year, some 100 victims had heart rhythms that indicated a reasonable chance of response to rapid treatment, according to EMS medical experts. Paramedics, firefighters (and more than a few co-workers, passers-by and family members) kept those victims alive to reach the hospital. Combined with the work of hospital-based medical teams, the result was successful treatment and release of 34% of the approximately 100 cardiac arrest victims.

Wake County’s 2006 performance is comparable to that of the Seattle/King County, Washington, EMS system, long regarded as an industry leader. According to a 2004 peer-reviewed research study, the Seattle area achieved a resuscitation rate of 30%. According to a USA Today report, Seattle’s cardiac-arrest survival rate exceeds 40%, with Boston, Mass., and Wake County not far behind. Wake County EMS representatives believe that several improvements in emergency cardiac care over the last 24 months help explain cardiac-arrest survivability in Wake County:

Bystander CPR awareness and early defibrillation by firefighters and others with access to automatic external defibrillators (AEDs).

New American Heart Association CPR guidelines (adopted by Wake County in April 2005), which call for more constant CPR chest compressions. Advanced care was streamlined to focus on good CPR and early defibrillation.

Application of new technology, like the “Res-Q-Pod,” which acts as an air-pressure regulator for the chest to improve blood circulation during CPR, which Wake County paramedics began using in 2006.

Streamlining of Raleigh-Wake Emergency Communications Center dispatch procedures which save an average of one minute, 16 seconds on initial EMS dispatch to cardiac arrest patients, a time savings that can mean the difference between life and death.

“Wake County’s EMS system continues to be a success story,” said Wake County Commissioner Paul Coble, who chairs the Board of Commissioners’ Public Safety Committee. “It has taken a lot of work to improve delivery of quality emergency medical care, both in efficiency and effectiveness, and we won’t rest on our laurels.”

“We can do even better,” said Board of Commissioners Chairman Tony Gurley. “As more people learn CPR, as we place more AEDs more strategically in the community, and as our EMS system continues to improve, more cardiac-arrest victims will walk out through those hospital doors.”

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Warning: mktime() [function.mktime]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for 'GMT/0.0/no DST' instead in /usr/home/wakeem/www/htdocs/blog/wp-includes/functions.php on line 14

Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for 'GMT/0.0/no DST' instead in /usr/home/wakeem/www/htdocs/blog/wp-includes/functions.php on line 23

Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for 'GMT/0.0/no DST' instead in /usr/home/wakeem/www/htdocs/blog/wp-includes/functions.php on line 25

Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for 'GMT/0.0/no DST' instead in /usr/home/wakeem/www/htdocs/blog/wp-includes/functions.php on line 27

Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for 'GMT/0.0/no DST' instead in /usr/home/wakeem/www/htdocs/blog/wp-includes/functions.php on line 28

February 25, 2007

Wake EMS Uses New Tools During Cardiac Arrest

Continuing in it’s aggressive management of victims of cardiac arrest,the Wake County EMS System is using new tools to aid in resuscitation.

Vidacare's EZ-IO®

Vidacare’s EZ-IO® provides rapid vascular access during cardiac arrest or severe trauma.
Wake EMS was an early adopter of adult intraosseous routes for medication and fluid delivery. Using the battery powered handle the needle can be placed in a matter of seconds. No more searching for IV access in critical times.

With a coordinated team of firefighter first responders and County paramedics, Wake’s revival rates is one of the best in the Nation.

In addition to rapid vascular access, the Wake EMS System uses a device on the end of the endotracheal tube that maintains pressure in the cadio-pulmonary vascular bed aiding in cardiac blood flow.

The ResQPOD Circulatory Enhancer® from Advanced Circulatory Systems,INC.

ResQPOD Circulatory Enhancer®

is used in conjunction with uninterrupted CPR and continuous capnography.

[from the ACSI’s website] … Sudden cardiac arrest, traumatic injury, heat stroke and the common faint, for example, all result in states of low blood flow or perfusion. In each case, a lack of adequate blood flow back to the heart contributes to the low blood pressure. States of low blood flow impair the body’s circulatory function, which delivers oxygen to the body’s vital organs and removes toxic cellular waste.
ACSI’s circulatory enhancer technology uses inspiratory impedance to increase blood flow to the body’s vital organs. It is unique in that it enhances the body’s biophysical performance without depending upon pharmaceutical or other outside agents. This patented inspiratory impedance technology uses the relationship of the heart, lungs and thorax to increase venous blood return to the heart…

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Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for 'GMT/0.0/no DST' instead in /usr/home/wakeem/www/htdocs/blog/wp-includes/functions.php on line 23

Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for 'GMT/0.0/no DST' instead in /usr/home/wakeem/www/htdocs/blog/wp-includes/functions.php on line 25

Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for 'GMT/0.0/no DST' instead in /usr/home/wakeem/www/htdocs/blog/wp-includes/functions.php on line 27

Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for 'GMT/0.0/no DST' instead in /usr/home/wakeem/www/htdocs/blog/wp-includes/functions.php on line 28

Warning: mktime() [function.mktime]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for 'GMT/0.0/no DST' instead in /usr/home/wakeem/www/htdocs/blog/wp-includes/functions.php on line 14

Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for 'GMT/0.0/no DST' instead in /usr/home/wakeem/www/htdocs/blog/wp-includes/functions.php on line 23

Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for 'GMT/0.0/no DST' instead in /usr/home/wakeem/www/htdocs/blog/wp-includes/functions.php on line 25

Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for 'GMT/0.0/no DST' instead in /usr/home/wakeem/www/htdocs/blog/wp-includes/functions.php on line 27

Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for 'GMT/0.0/no DST' instead in /usr/home/wakeem/www/htdocs/blog/wp-includes/functions.php on line 28

Warning: mktime() [function.mktime]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for 'GMT/0.0/no DST' instead in /usr/home/wakeem/www/htdocs/blog/wp-includes/functions.php on line 14

Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for 'GMT/0.0/no DST' instead in /usr/home/wakeem/www/htdocs/blog/wp-includes/functions.php on line 23

Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for 'GMT/0.0/no DST' instead in /usr/home/wakeem/www/htdocs/blog/wp-includes/functions.php on line 25

Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for 'GMT/0.0/no DST' instead in /usr/home/wakeem/www/htdocs/blog/wp-includes/functions.php on line 27

Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for 'GMT/0.0/no DST' instead in /usr/home/wakeem/www/htdocs/blog/wp-includes/functions.php on line 28

February 4, 2007

I.C.E. SECTION of BLOG TO APPEAR SOON

ICE - Induced Cooling by Ems will debut in it’s own website in the next two weeks.

Cited as a major advancement in resuscitation, hypothermia can reduce cell and brain damage after a cardiac arrest.

This new site will help educate both the public and professional medical personnel. Readers will be able to follow our experience in Wake County.

Dr. Paul Hinchey will present current medical citations and the Wake County EMS Prehospital protocol for controlled hypothermia.

Future additions of podcasts and data tables will appear in the next month. The Wake EMS System is one of four in the United States that has a protocol for hypothermia post arrest.

 

Comments are welcome.

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