January 23, 2015
By Tina Taviano
In Lee County, Fla., we measure success one 9-ECHO-1 at a time. We track our rates of revival and survival from a cardiac arrest starting at the beginning of the call, through post-arrest, ending when the patient walks out of the hospital.
In 2013, Lee County EMS responded to 807 calls coded as 9-ECHO-1. Of these calls, we were able to identify 277 incidents in which the patient was transported. Records indicate that 32 cases involved successful resuscitation. Through the quality assurance process of call review, we found that the calltaker determined the cardiac arrest in 12 of these calls and encouraged the caller to perform effective CPR until the arrival of advanced life support.
These are the statistics and numbers found in computer-aided dispatch and patient care reports and hospital charts, and used primarily for recording information to document in records and billing.
What is success?
Let me put names to the voices of the callers and the faces of the survivors.
Jerry was coached by EMD Michelle Nevans to drag his wife, Lucy, onto the floor and provide CPR until EMS arrived. They defibrillated her and transported her as an “Ice Alert” (aka therapeutic hypothermia—once a patient’s heartbeat is restored, EMS staff quickly applies coolants to moderately lower a patient’s body temperature) to the hospital. Lucy has made a full recovery.
Jerry had no prior experience in giving CPR.
“She [EMD Nevans] stayed with me the whole time encouraging and instructing me,” Jerry said. “What seemed like a very long time was actually a very short time because she had me counting to 600 at two per second. Lucy’s family thanks you for returning a wife, mother, grandmother, and great-grandmother back to us.”
EMD Eric Schrader gave Cody CPR PAIs when his wife, Amanda, collapsed on their wedding night from a rare heart condition. Since Amanda couldn’t recall her wedding, the couple “re-lived” the day to create the memory they had expected.
The ability of Casey to give CPR to his father, Gene, from instructions provided by EMD Dan Liebal resulted in his desire to become a paramedic.
This list goes on. Each save and each life is celebrated.
Meanings of success
Many attempts to save a life after cardiac arrest aren’t successful “saves” by definition.
I was giving a tour of the communication center when, as the visitors were leaving, a woman in her mid-60s turned in my direction.
“I want to thank you—your staff,” she said, taking my hand in hers. “Last fall, you helped me when my husband had a heart attack.”
Her eyes started to tear up as she continued.
“You (the calltaker) convinced me to do CPR, and my husband lived for another seven days before he died,” she said. “Those seven days were priceless to our family. We wouldn’t have had that time together without what your staff did. I am forever grateful.”
I thanked her for her kind words.
“It’s what we do,” I said.
How often does your agency hear how the family feels about calling 9-1-1? Chances are the EMD seldom makes a lasting impression on the caller.
At Lee Control, we want our calltakers to recognize that they play a big part in the process. Lives are saved through their attentiveness, determination, and compassion in using protocol effectively.
Performing quality assurance reviews, maintaining certification requirements, and following protocols in a calm, competent, and confident manner do make a difference. From experience, we know that MPDS and CPR PAIs can make a difference.
Lee County serves a population of 650,000, and during snowbird season, the population swells to 1.2 million. Lee Control is a secondary PSAP and a dual-accredited ACE (medical and fire) dispatching for 19 fire districts and Lee County EMS.