Today, in the United States, Sudden Cardiac Arrest (SCA) will take more adult lives than colorectal cancer, breast cancer, prostate cancer, auto accidents, AIDS, firearms and house fires combined. This killer strikes without warning and, unless immediate specific actions are taken, a person’s chance of survival is next to zero. Fortunately, the treatment options for this disease are rapidly evolving, and the proper implementation of certain treatment strategies by Emergency Medical Services (EMS) providers has allowed communities across the United States to achieve survival rates as high as 50%.
One community that has achieved these outstanding survival rates is the City of Henderson,
Nevada. Located in the southern tip of the state, Henderson is the second largest city Nevada.
All EMS services including Advanced Life Support (ALS) first response and transportation are
provided to the city by the Henderson Fire Department.
In addition to following the 2010 American Heart Association’s (AHA) guidelines for the treatment of cardiac arrest, the department has implemented the following treatment strategies, which it believes are key to its success.
First, ensuring that chest compressions are performed as soon as possible and optimizing the correct performance of them, while minimizing interruptions to them is a vital. In 2010, the AHA affirmed this by reversing the long standing order of the steps for CPR from ABCs to CAB, putting the most important emphasis on the performance of quality chest compressions. The department ensures this goal is accomplished by utilizing the Laerdal/Philips Medical Q-CPR feedback device during all resuscitations. This device is able to give responders real time feedback on the correct application of chest compressions, and provide visual and audible alerts for when the timed chest compressions are not being accomplished.
The second treatment strategy utilized is minimizing the time it takes for a patient to receive defibrillation, if it is indicated. The city has a Public Access Automated External Defibrillator (AED) program that has placed over 75 AEDs in all public buildings, recreation centers and public pools. AEDs are also placed on all police vehicles. The nearest police unit is dispatched with EMS to minimize the time it takes to get a responder trained in CPR and equipped with an AED to a patient’s side. This treatment strategy alone is responsible for four lives saved in Henderson in 2011.
The last treatment strategy is the creation of team-based treatment procedures, where defined roles and responsibilities are spelled out and then applied in a consistent fashion. Just like the coordinated actions of a NASCAR pit crew, the department has developed EMS Task Standards that split up the essential actions to be completed among responders on the scene. These task
standards are used in every single training evolution and on actual calls. The results are that all responders on a call, regardless of the individuals present, have standard expectations of what needs to be done and how to accomplish it. This standardization allows for more efficient patient care, as well as the reduction of medical errors.
While sudden cardiac arrest may be a leading killer of American adults, the application of these specific steps, while following the AHA guidelines, has allowed the City of Henderson to achieve and maintain survival rates that are among the top in the nation.