This supplement, sponsored by Philips Healthcare, illustrates pre-planning and operational changes that EMS agencies have effectively used to improve their delivery of patient care and their resuscitation results. Articles address high-quality CPR, therapeutic hypothermia, the chain of survival and preparing for EMS care at mass-gathering events.
This supplement is both a tribute and challenge to prehospital EMS systems. It’s a tribute because it recognizes multiple areas where EMS agencies have been leading the way in clinical innovation, technology, educational and operational planning, and resuscitation advances.
It’s a challenge because in illustrating pre-planning and operational changes that EMS agencies have effectively used to improve their delivery of patient care and resuscitation results, it challenges your agency to do the same.
The treatment of out-of-hospital cardiac arrest (OOHCA) has long been one of the driving factors in determining what EMS care looks like in the U.S. From system design to equipment carried and techniques taught, much of what we do in EMS has been geared toward improving the survival rates for patients who suffer from this occurrence.
It’s 9 a.m. on a warm March morning. You and your partner just finished breakfast at the beginning of a 24-hour tour of duty. All things considered, you’re expecting a typical shift, and the citizens in the district you protect are expecting a typical day at work. Soon after breakfast, things drastically change for you, your partner and several employees of a local business.
In 2005, the American Heart Association (AHA) recommended therapeutic hypothermia for post-arrest management for patients presenting in ventricular fibrillation (Class IIa) and those presenting with bradyasystolic rhythms (Class IIb). In 2008, this recommendation appeared again in AHA’s consensus statement on “Post-Cardiac Arrest Syndrome.” And earlier this year, the AHA published the policy statement “Regional Systems of Care for Out-of-Hospital Cardiac Arrest,” noting that the “time to implement these systems of care is now.”
Hundreds of thousands of spectators gather every Memorial Day weekend to sit or stand in the sun for hours, many of them pressed into the crowded infield of the Indianapolis Motor Speedway. Cars fly by them at speeds in excess of 200 mph, sometimes resulting in ultra-high-speed crashes. The Indianapolis 500, the crown jewel of the IZOD IndyCar Series, is known as “The Greatest Spectacle in Racing,” with the largest single-day attendance of any sporting event in the world, held at the world’s largest stadium, the Indianapolis Motor Speedway (IMS).
These two words bring instant concern to the medical director of a marathon, as well as reflection on the preparation and planning leading up to and during an event. Although the majority of collapsed-athlete calls tend to be for benign conditions related to the normal physiology of the event and prolonged activity—such as dehydration and heat-related injuries, altered mental status and diabetes-related problems—your response system must be prepared for and anticipate the worst.