Time / cardiac arrest patients

[Guest guest]

Time is of the essence with cardiac arrest patients

By , USA TODAY

When it comes to saving victims of sudden cardiac arrest, time is critical.

Two studies in Thursday's New England Journal of Medicine show a sharp

difference in survival when help comes quickly — especially when fast-thinking

bystanders do CPR, and when they have an automated external defibrillator (AED)

available and are able to deliver a shock within eight minutes. (Related story:

CPR, defibrillators as good as medics, research suggests)

About 60,000 people a year collapse in sudden cardiac arrest, in need of a shock

to restore the quivering heart to a healthy rhythm. When a shock is not

immediately available, the patient needs CPR in the meantime.

A USA TODAY investigation published last year found that even eight minutes is

too long to wait for intervention, that lives are lost or saved within six

minutes.

" Eight minutes is not adequate, " says White, a Mayo Clinic researcher and

medical director for the early defibrillation program in Rochester, Minn. His

city has measured to the second how much time passes between a 911 call and the

instant a shock is delivered to a cardiac arrest patient.

His data show that victims shocked within six minutes almost always live; those

shocked after six minutes almost always die.

The newspaper's investigation showed that most of the cities that have made

major strides to save more of these victims have focused on ways to cut their

response time from the time a 911 call is received to the delivery of the first

shock.

Cities that continue to rely on outdated measures of response time, from the

time a call is received and crews begin to drive toward the victim to the moment

their rescue rig stops at the curb, most often have dismal survival rates.

" If you are looking at wheels rolling and wheels stopping as your marker, it's a

mistake, " says O'Connor, who heads the EMS committee for the American

College of Emergency Physicians.

One of the studies out today, the Ontario Prehospital Advanced Life Support

study, shows how many minutes are spent between call and shock:

• Telephone call to crew notification: .6 minutes

• Crew notification to arrival at scene: 4.2 minutes.

• Arrival to reaching patient's side: .9 minutes.

• Patient's side to heart analysis: 1.6 minutes.

• Analysis to first shock delivered: .3 minutes.

• Total time from call to shock: 7.6 minutes.

Cities that scrutinize the time it takes to reach victims of cardiac arrest find

holes in their system. And fixes are particularly easy with modern technology.

But the best outcomes occur when bystanders intervene immediately instead of

waiting for paramedics. When bystanders manage to shock a person with an AED

before emergency crews arrive, survival rates double, according to the second

study published today.

" We had a cardiac arrest in an athletic club and it took eight minutes (for help

to arrive), " White says. " The fire, police or ambulance just couldn't get there

faster. We put an AED in there. "

Experts caution that it might not be cost-effective to put AEDs, which cost

about $1,800, into every building or public place, although many cities have put

the devices in museums, parks and on golf courses, saving lives.

First, experts say, cities should make sure that all first responders, including

police officers, firefighters and public park personnel, have AEDs and are ready

and willing to rush to the aid of cardiac arrest victims.

Also, more cities should launch massive public CPR training programs so more

bystanders can intervene while waiting for the lifesaving shock.

" Look at the systems already in place, " White says. " Taxpayers are paying for

them. Exploit them to the max. "

[Guest guest]

> --- Silsbee EMS wrote:

>

> >

> > Not to be arguing with you or even not agreeing with you as I do agree

> > with what you state but fell all the facts need to be displayed. I have

> > been on with a micu unit

>

> Did survive?

>

Bet he was a lot thinner....

Mike " The other Mike' Hatfield

[Guest guest]

> --- Silsbee EMS wrote:

>

> >

> > Not to be arguing with you or even not agreeing with you as I do agree

> > with what you state but fell all the facts need to be displayed. I have

> > been on with a micu unit

>

> Did survive?

>

Bet he was a lot thinner....

Mike " The other Mike' Hatfield