August 2012 Supplement, EMS State of the Science 2012

Introduction

Cardiac, respiratory and resuscitation medicine is rapidly changing with new protocols, procedures, thought processes, treatment devices, training and operations. More importantly, research and resuscitation outcomes are validating new approaches to care and driving new approaches to resuscitation. Consequently, care in the field must adapt.

This EMS State of the Science supplement, developed in cooperation with the U.S. Metropolitan Municipalities EMS Medical Directors Consortium and our sponsors, features articles that address key resuscitation issues.

Q&A with HeartRescue Project Manager Joan Mellor

The Medtronic Foundation’s Joan Mellor oversees the Foundation’s HeartRescue Project, a collaborative initiative designed to improve how SCA is recognized, treated and measured in the U.S. Most importantly, it’s an ambitious effort to change the way we collectively respond to sudden cardiac arrest (SCA). Partners involved in the project are working to improve SCA survival rates by 50% over five years by implementing measurable, evidence-based best practices among citizen bystanders; prehospital responders such as police, fire and EMS; and hospitals.

Trends & Changes in Cardiac Care

Study Determines Optimal Chest Compression Rate

The quality of CPR and chest compressions are key factors for survival from cardiac arrest.1 Over the past 50 years, there has been a progressive increase in the recommended rate of chest compressions during CPR.In 1960, the recommended rate was 60 compressions/minute; this increased to at least 100 compressions/minute in the latest guidelines from the American Heart Association (AHA) in 2010.(1—4) However, guidance is not provided for a maximum chest compression rate.

Web Bonus: Study Proves IO Infusion Is Effective in Therapeutic Hypothermia

The practice of reducing the core temperature of a cardiac arrest or stroke patient to protect the brain and increase the probability of a full return to normal function is rapidly gaining acceptance and practice in the EMS arena.

Web Bonus: Saving Lives in Pennsylvania

Recent investigations have demonstrated that a handful of communities have achieved remarkable cardiac arrest survival rates exceeding 15%. However, most Americans still live in locations with survival rates that are much lower. Many of the communities with high survival rates have achieved improved cardiac arrest outcomes by focusing on the entire chain of survival; that is, they support a full bundle of interventions to provide the best resuscitation care for patients with cardiac arrest. This “bundle of care” approach usually includes:

Depth Perception

The importance of quality CPR for victims of cardiac arrest is beyond question. Real-time guidance and feedback on chest compression rates is already helping EMS teams perform better CPR. Now, more accurate feedback for chest compression depth is on the horizon, with a new application in development by Physio-Control.

The Merits of Mechanical CPR

Bonus Videos
 >> Watch how the AutoPulse is applied using two-person pit crew deployment at EMS Today in March 2012. 

Watch how Cypress Creek (Texas) EMS has mastered the rapid application of the LUCUS 2 device.

Debate Heats Up Over Who Should Handle Richmond (VA) 911 Calls

The debate over who should handle Richmond’s 911 calls intensified in Richmond as two city agencies presented their cases to City Council members.

San Jose (CA) Implements Fees for 911 Medical Calls

The San Jose City Council gave initial approval to a plan that will charge residents a first responder fee when they call 911 for medical…