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EMSA: Cardiac Arrest Survival Rates Improved with New Method

TULSA, Okla. -- A new method for dealing with cardiac arrest patients may be behind a marked improvement in survival rates for EMSA, agency officials said. The survival rate for 2010 was 42 percent, up from 38 percent in 2009. The agency expects that practices put into place after 2010 will cause even higher rates for 2011 and 2012, said Dr. Jeffrey Goodloe, who serves as medical director for EMSA, the Tulsa and Oklahoma City police departments and other agencies in the area. EMSA already has an above-average cardiac survival rate, he said.

"We've had a great system for years, but there's always a chance to fine-tune," he said The agency, which supervises a contractor providing medical service to more than 1 million people in Tulsa, Oklahoma City and surrounding cities, has a goal of a higher than 50 percent cardiac arrest survival rate, he said.

EMSA responds to about 1,100 cardiac arrest patients a year. In 2010, paramedics began cooling their cardiac arrest patients with an IV of saline chilled to near freezing. The cooling blunts some of the body's negative responses to a lack of oxygen that results from the arrest, Goodloe said.

Toward the end of 2011, EMSA began training paramedics to perform chest compression on cardiac arrest patients with a metronome to ensure they get as close as possible to the optimal timing. Soon after, the agency implemented a specific team approach to cardiac arrest responses. It's similar to a pit crew at a racing track.

Every responder has a specific role, depending on how many responders there are. The team approach works for two responders up to six. Everyone at the scene has a playbook of sorts, said Jason Likens, EMSA paramedic. "There's no more guesswork on who's going to do what when they get there," he said. The new methods haven't been difficult to implement and have actually made responding to cardiac arrest a bit easier, he said.

"There's a really rich training program that backs up the protocol change," he said.

The data used to calculate survival rate include only those cardiac arrests that are either seen or heard by someone. The patient must also receive some form of bystander CPR and have a heart rhythm that will respond to the shock of a defibrillator when emergency medical personnel arrive. A person is ruled to have survived when he or she is discharged from the hospital. Goodloe said that working toward survival of a cardiac arrest begins with a bystander who can alert medics and start CPR or use an automatic external defibrillator.

"Everyone is improving in recognizing cardiac arrest - what could be cardiac arrest - calling 911 and starting CPR," he said.

Agencies other than EMSA, such as area fire departments, also play a big role in cardiac arrest survival because sometimes they are the first on scene, he said.

"We're all in this together," he said. More about CPR Health officials now suggest hands-only CPR, which is CPR without mouth-to-mouth breaths. It is for when you see a teen or adult suddenly collapse outside of a hospital, such as at work or home. The two steps for hands-only CPR are: 1 . Call 911 (or send someone to do that). 2 . Push hard and fast in the center of the chest.



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