Cardiac & Resuscitation, Community Paramedicine and Mobile Health, Exclusives, Patient Care

Early Citizen Response/CPR/AEDs; Uninterrupted Compressions & Dispatcher-assisted CPR Emphasized by EMS Experts at CPR Summit

Dr. Mickey Eisenberg and Dr. Freddy Lippert at the Cardiac Arrest Survivors Summit.

Editor’s Note: This is a special report by JEMS Editor-Emeritus A.J. Heightman from the Cardiac Arrest Survivors Summit, sponsored by the Citizen CPR Foundation, in Seattle.

Introduction

I had the great pleasure of catch up with one of my favorite people, and most influential expert in EMS, Dr. Mickey Eisenberg, in Seattle at the Cardiac Arrest Survivor Summit. Dr. Eisenberg is the founder and leader of the Resuscitation Academy based out King County, Washington. With over 7,500 cardiac arrest resuscitation survivors in King County as a result of his efforts, Dr. Eisenberg truly is the “Father of Resuscitation” in this country – even if he is too humble to admit it.

A.J. Heightman with Dr. Mickey Eisenberg.

I had the honor of giving Dr. Eisenberg a lifetime achievement award from JEMS several years ago. He has truly been an inspiration to me and thousands of others in our careers. His ever-present smile and extreme knowledge is a gift to all of us.

We discussed some current resuscitation concepts that are working and several that are still questionable. I will be writing more on this in the next few weeks. In the meantime, read Dr. Eisenberg’s inciteful books to help improve resuscitation in your system.

We also discussed the success of the Washington State Medic One System in delivering ALS with a few highly trained paramedics. The Medic One Program began in the Seattle Fire Department in 1970 when the first group of firefighters were trained as paramedics in cooperation with Harborview Medical Center and the University of Washington. Since then, the Medic One Program has gained notoriety because of the training, dedication and prehospital emergency patient care paramedics deliver in Seattle.

Dr. Eisenberg credited Dr. Leonard Cobb and Dr. Michael Copass with being his mentors and inspiration to spread the highly successful Medic One ALS response system throughout Washington.

Dr. Michael Copass and Dr. Leonard Cobb developed the highly effective Medic One ALS system in the late 1960s.

More coverage: Cardiac Arrest Survivor Summit Opens with Inspirational Double Resuscitation Story

Conference Emphasis Areas

Dr. Mickey Eisenberg and the King County WA Medic One system have saved more than 7,500 cardiac arrest victims.

Dr. Eisenberg, each of the speakers at the 2019 Cardiac Arrest Survivor’s Summit, and I strongly believe that keys in improving cardiac arrest include:

1) More emphasis, diligence and evaluation of dispatch center CPR instruction to callers.

Teaching dispatchers to better recognize cardiac arrest through areas like the recognition of agonal breathing were also emphasized throughout the Cardiac Arrest Survival Summit.

Places like Singapore and Copenhagen have adopted Dr. Eisenberg’s and Seattle’s ideas and really ramped up their telephone CPR delivery which has greatly improved their resuscitate and results.

In Copenhagen, they are utilizing artificial intelligence (AI) – provided by software developer Corti – to assist dispatchers in recognizing symptoms and scenarios of cardiac arrest.

Dr. Freddy Lippert explains how citizen responders now respond to the home of cardiac arrest victims, arriving earlier than emergency responders.

2) High quality, uninterrupted compressions must be provided by rescuers

All speakers emphasized that our emphasis must be on keeping compressions going and limiting breaks in compressions to < 10 seconds at all times. This has shown great impact on resuscitation results.

3) Mobilizing the masses (citizens) as initial responders

EMS systems like those in Singapore and Copenhagen have been very successful with mobilizing the public to retrieve AED’s and deliver CPR as early as possible after an arrest through cellphone alert programs such as PulsePoint and, in Europe, the highly touted “Good Sam” app.

In Copenhagen, citizens are dispatched — even to homes — to deliver care and AEDs to collapsed patient, amazingly beating first responders by minutes.

Denmark’s outstanding improvement results with CPR and bystander defibrillation in public locations.

Dr. Ng Yih Yng from the Center for Healthcare Innovation in Singapore has been very successful in developing training, personal reviews and dispatch center algorithms in Singapore to greatly increase the delivery of telephone CPR and resultant cardiac arrest saves.

Dr. Eisenberg, and Copenhagen EMS Director Dr. Freddy Lippert, emphasized during their joint keynote lecture how time flies in our disadvantage during a cardiac arrest and that – if we arrive at a patient and 10 minutes – our chances of resuscitation success and patient survival are very low.

Dr. Eisenberg referred to the 10-minute apnea phase as the “slope of death,” emphasizing that interventions and improvements in resuscitation practices and procedures can greatly change the slope of death.

The “slope of death.”
The delays that occur during the “slope of death.”

Global Resuscitation Alliance to Play Key Roll in the Future

Therefore, all agree that we must mobilize citizens to get hands on the chest and deliver AED’s as soon as possible. To do this, a Global Resuscitation Alliance (GRA) has been established and is working in a wonderful, professionally competitive manner to improve resuscitation practices by 50%. The Global Resuscitation Alliance has agreed to work toward implementation on 10 Best Practices on Implementation that are shown on the photo below. Review the countries, their work and their success to date at: https://www.globalresuscitationalliance.org/.

You can download the 2018 updated Global Alliance “Acting on the Call” document that includes 27 case reports highlighting the global ferment in improving survival from cardiac arrest at: https://www.globalresuscitationalliance.org/wp-content/pdf/acting_on_the_call.pdf

The Global Resuscitation Alliance 10 Best Practices on Implementation.
Global Resuscitation member countries.

Make it a 2020 goal for your system to follow guidance from articles and recommendations by these leaders and Alliances.

Dr. Eisenberg’s books (Masterpieces of resuscitation), available on Amazon.com

Resuscitate!: How Your Community Can Improve Survival from Sudden Cardiac Arrest

Life in the Balance: Emergency Medicine and the Quest to Reverse Sudden Death

Resuscitation Academy eBook – PDF Version of “Ten Steps for Improving Survival from Sudden Cardiac Arrest

The “Resuscitation Academy” Website