Washington, DC (5/30/2008)

Dr. Brent Myers, Medical Director of the Wake EMS System presented to the Society of Academic Emergency Medicine the results of implementation of new methods of CPR, adjunct airways and induced hypothermia.

The report represents a clinically significant increase of survival from out of hospital cardiac arrest where these new methods were used.

The complete presentation is available at:

www.wakeems.com/saem

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.

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

Wake EMS is looking to recruit the best and the brightest.

As one of the nations most progressive EMS agencies,
Wake County EMS is seeking applications from the nations best EMS workers.

District Chief Jeffrey Hammerstein, Acting District Chief Chad Turner, Paramedic Association President Tim Martin and Senior Medic Patrick O’Boyle are enroute to the EMMCO WEST EMS Symposium.

UPDATE 3/24/2007

Wake County Paramedics Tour Steel Country Sharing
New Opportunities in EMS

On March 8, 2007, four Wake County EMS paramedics, Chad Turner, Tim Martin, Patrick O’Boyle and Jeff Hammerstein, made a recruitment trip to Sharon, Pennsylvania. Located in the Northwestern part of the state, the area is served mainly by private ambulance companies. The Wake EMS recruitment and information booth was made available to participants of the Emergency Medical Management Cooperative (EMMCO) West Symposium, which is an annual EMS educational convention held in the Pennsylvania region north of Pittsburgh.

Over the past three years what procedure or medication has made the most difference in the way we practice care in the prehospital setting?

Advances in caring for the patient who is in Congestive Heart Failure.

Prior to the availability of portable continuous positive airway pressure (CPAP) devices, patients were treated for acute respiratory distress with intubation, medications and extended intensive care stays. The addition of portable CPAP systems has cut the need for advanced airway care by as much as 50%. Reduced hospital stay and limited exposure to possible hospital acquired infections.

A recent study (Hubble, et.al) showed that the number needed to treat to prevent possible death was 6. For every 6 patients treated with CPAP the community avoids one bad outcome (death or disability).

According to the American Heart Association, people 40 and older have a 1 in 5 chance of developing CHF in their lifetime. Nearly 5 million people in the United States—mostly older adults—already have CHF, and the number of people with CHF keeps rising. About 550,000 people develop CHF each year.

Changes in protocols to include the early use of CPAP have led to better patient outcomes and reduced hospital costs. A win-win for both the patient and the community.

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.

Many Patients From Gulf Region In Triangle To Avoid Rita
Triangle Rita Preps

Posted: Sep 23, 2005

RALEIGH, N.C. — Some hospital patients from the Gulf hoping to escape from Rita’s projected path are in the Triangle. They arrived at RDU International early Friday morning.

Twenty ambulances, 40 paramedics and dozens of doctors and nurses are all part of the response by Wake County and surrounding counties to treat patients in the path of Rita.

“We’re ready to go. We had lots of opportunity to practice,” said Wake EMS Chief Skip Kirkwood.

In response to Hurricane Rita’s potential impact, the Federal Emergency Management Agency activated the National Disaster Medical System. According to the NDMS, more than 2,000 patients will need to be flown out of the Hurricane Rita impact area and redistributed across six possible NDMS locations around the country that can accommodate the patients in their surrounding hospitals.

At 5:30 a.m. Friday, the first group of evacuees from Texas arrived at RDU with 32 people on board, of which 10 were hospitalized. The second plane landed at 8:15 a.m. with 100 people on board, of which one person was hospitalized.

A real-life run-through came after Katrina hit. Emergency responders turned a National Guard hangar at RDU internationl into a makeshift clinic. Now, it will be ready to meet the health-care needs of patients from Texas.

“The information that we have now is that of these 32 patients, 15 of them are wheelchair patients, another 15 are medical status unknown and require evaluation by a physician,” Kirkwood said.

Ambulances are ready to transport the most critical patients. The others will go to the triage center at the armory, receive treatment and then transported to a hospital.

Twenty-two hospitals in eight counties will make room for the patients. More patients are expected to arrive later Friday morning.