Editor’s Note: The following is a guest column from Beth Harrington, assistant director for emergency medical services at the Tompkins County Department of Emergency Response.
Contact me at firstname.lastname@example.org to submit guest columns.
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The lungs stop breathing and the heart stops beating, sure signs of death. But that is not always the outcome of such an event. A recent article in a local media source talked about saving a man’s life with CPR. It was great to see recognition of the people involved in this “save,” but the story did not explain the complex interface of people, agencies and systems which exist within Tompkins County to support such life-saving medical interventions.
The American Heart Association calls it the “chain of survival.” And it begins with public education so that people can recognize serious medical problems in a timely fashion and call for help (911). For hospitals, health care workers and Emergency Medical Services (EMS) agencies, such outreach is integral part of their mission. Locally, you will see these people at health fairs, speaking to senior citizens groups, providing literature on various health problems, and sharing health news on their websites.
The second part of the chain of survival is early CPR (cardiopulmonary resuscitation). Many agencies offer CPR training to the public. It is a simple skill that does save lives. But even without specific training, a Tompkins County 911 Dispatcher can talk a caller through CPR and will stay on the line with you until help arrives. All these dispatchers are also trained in CPR, as well as in a dispatching system that includes “pre-arrival instructions.” Such instructions were given to the man’s wife, who started CPR. Also, our local 911 Center support a countywide communications system that can connect many different agencies, from firefighters to EMS personnel, to law enforcement and the hospital, that might be involved in responding to a cardiac arrest.
Early defibrillation (or delivering “shocks”) is the next part of the chain. Earlier this year, the Tompkins County Legislature approved the initiation of a County AED (automated external defibrillator) program, and placed 48 AEDs in all county buildings, as well as in the Sheriff’s road patrol cars. In the recent event, it was a Deputy Sheriff, also trained in CPR, who was the first on the scene, and utilized the AED. The local fire company rescue squad arrived shortly after the Deputy, took over CPR and AED operations, and in rapid sequence, the ambulance with ALS (advanced life support) certified personnel and equipment arrived and took over care of the patient. Early ALS intervention is the next link in the chain. All ambulances in Tompkins County can provide ALS care; there is also a dispatching policy to assure that ALS care is dispatched quickly.
There is a life-saving slogan that applies to people experiencing heart problems, SURVIVE, DON’T DRIVE. These ALS ambulances can provide the same early emergency care with equipment, medications and trained personnel as that of about the first 15 minutes of Emergency Department Care. In the event being discussed, the man was talking with ambulance personnel when they arrived at the Emergency Department at the local hospital.
The final link of the chain is “post-resuscitation” care and our local hospital is most capable of providing quality care in this type of situation. There are only 11 hospitals in all of New York State that are nationally certified to do primary PCI (percutaneous coronary interventions), or more simply, cardiac catherization, and CMC is one of them. Emergency Department personnel were already talking with the PCI Team when the patient arrived in the ED, and he was quickly taken for a catherization, then sent to the Intensive Care Unit for monitoring prior to his discharge.
A “save” such as described is not all that uncommon in Tompkins County. But those saves are not because of the correct alignment of the stars or luck, but rather the result of an established system in this county that supports such collaborative efforts between many different organizations and personnel. Saves are the result of the teamwork of both the first responders and health care personnel who provide the direct patient care as well as those “behind the scenes” people, such as County Legislators and hospital administrators, who assure that the infrastructure is in place to support such efforts. Kudos to all for a job well done!
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