Cardiac & Resuscitation, Patient Care, Training

Pennsylvania Offers a Creative Approach to Pit Crew Training

Issue 11 and Volume 39.

It all started with a steak lunch. Nathan Harig, assistant chief of administration for Cumberland Goodwill EMS in Carlisle, Pa., created a competition within his agency to pick the top performing CPR “pit crew” team. Videotapes were made of his teams as they competed against each other practicing the new pit crew protocol—a system of continuous high-quality CPR with clearly defined roles for all rescuers involved. Winners were treated to a steak lunch cooked by Chief Harig.

Pennsylvania pit crew CPR winners Centre LifeLink EMS. Photo courtesy RedFlash Group


Senior Research Coordinator for the Pennsylvania HeartRescue Project Nina Li had just conducted a survey of the agencies across the state most involved with HeartRescue project, an ambitious multi-partner, multiyear initiative funded through grants from Medtronic Philanthropy to improve sudden cardiac arrest survival rates by 50% in targeted populations. Results were showing that agencies wanted a training video to help reinforce the pit crew approach. “The steak dinner came to mind,” Li said. “Why not hold a statewide video contest of their agencies performing the pit crew protocol so we could motivate the teams to train and practice?”

Douglas Kupas, MD, and Richard Gibbons, EMT-P, both with the Pennsylvania Department of Health, were selected to judge the contest. Li received 10 videos from various agencies across the state. All were judged on how well they presented and adhered to the protocol criteria.

Laerdal Medical sponsored the prizes: $1,000 for first place, $500 for second, and two, third place sponsorships of $250—awards that could be used to purchase training equipment. And since the goal was to promote education, the winning team was sent to the Emergency Cardiovascular Care Update 2014 Conference and the second place team was awarded a luncheon with Ben Abella, MD, MPhil, conducting training for the team.

All participating teams had fun and felt participation was helpful to them in perfecting the protocol. For Li and her team it was educational as well. They were able to see how the teams varied the protocol to improve execution. For example, “the winning team would count in sets of 15 compressions and then ventilate,” Li said.

In addition, it was clear that some parts of the protocol were retained better than others. “We can now figure out why all the teams seem to remember things like letting the chest recoil fully, but other parts of the protocol weren’t understood as well by everyone.” Moving forward, “we are planning on sending feedback to the teams to help them refine the protocol,” Li says.

A compilation video is now available statewide for agencies to use during training. You can view it on the Pennsylvania Department of Health Bureau of EMS website or at Be sure to stay tuned to the end.

The steak lunch wasn’t the best reward for Harig’s teams. That came a month later when members of his team saved the life of 19-year-old Sadie Hockenberry using the pit crew protocol.