Wednesday, April 06, 2005

Ambulance Response slower? Consider an AED

My wife and I are both First Aid/CPR/AED trained, but the sad part is, CPR, even when done properly, is only about 5% effective in dealing with heart attack. Starting CPR before the fire truck gets there doubles the survival rate, but I like to load my dice when it's my life we're talking about.

This gizmo increases the odds significantly for geezers like us; that is, if you'd like to have something to do while waiting for the fire truck. More below, about waiting for the ambulance....

Test Driving a Home Defibrillator
As Heart Devices Become More Accessible, We Try One
Giving 'Matt' a Shock
April 6, 2005; Page D1, Wall Street Journal

When I had a heart attack seven years ago, I arrived, conscious and alert at a hospital emergency room, where the doctors and nurses proceeded to save my life. In many cases, the standard kind of heart attack I suffered doesn't kill instantly, and offers a decent chance of survival if the patient is cared for properly -- partly because the heart, while damaged, is still beating.

But there's another type of heart attack that comes on without warning, leaves the victim unconscious, and kills within minutes if emergency treatment isn't rendered on the spot. It's called sudden cardiac arrest. In sudden cardiac arrest the heart suddenly stops beating, and the patient will die unless it can be started again within a few minutes. According to the American Heart Association, hundreds of thousands of Americans die each year from such cardiac arrest. The main tool for saving these victims is a device called a heart defibrillator, which uses an electric shock to restart the heart's beating.

"Cardiac arrest is reversible in most victims if it's treated within a few minutes with an electric shock to the heart to restore a normal heartbeat. This process is called defibrillation," the association explains on its Web site. "A victim's chances of survival are reduced by seven to 10% with every minute that passes without defibrillation. Few attempts at resuscitation succeed after 10 minutes."

In cardiac-arrest cases, it's crucial to call 911 immediately so emergency medics can speed to the scene. They can use a defibrillator to shock the heart into beating again. But now, you can also buy a simple heart defibrillator meant for home use by average people without medical training. You can use the device to try to restart a stopped heart even before the medics arrive. It even helps you administer Cardio-Pulmonary Resuscitation (CPR).

This week, my assistant Katie Boehret and I tested this new device, the HeartStart Home Defibrillator from Philips. The HeartStart was designed to be simple enough for anyone to use, regardless of age, technical skill or medical knowledge. It is clearly marked with directional drawings and language, and even has vocal prompts that guide the user through each step.

(click on link above for full story)

And, why is this relevant?

Well, AMR, the ambulance company who operates EMS in most of the county, has gotten an adjustment from the county in its contract. Its response time standard in urban areas has gotten slower by two minutes, on the pretext that the CCFD No. 1 fire truck will arrive quicker, and the fire trucks have paramedics and/or EMTs. AMR is 'rebating' back to the county an adjustment in the cost of the service.

Also on background, here's a little more information about the history of ambulance service in the county.

This does not apply to the Lake Oswego Fire Department (1 ambulance), the Molalla (2 ambulances) and Canby (3 ambulances) Fire Districts, which provide their own ambulance service (all backed up through mutual aid agreements).

Nor does it apply to 'rural' and 'frontier' areas of the county; the latter's arrival time is more than half an hour. CCFD#1 is the second largest fire district in Oregon, with over 170 square miles to cover, BTW, and from what I've seen in a couple of years of repeating involvement, they do an excellent job, but there's only so much they can do with the resources provided.

For reference, back in 2000, AMR met their performance time standard 25% of the time in Lake Oswego, West Linn and other areas west of the Clackamas river, and 90% of the time east of the river.

Would you like to increase your odds? Step away from the cheeseburger, take a walk, and plan for disasters, even the small-scale, personal ones.

BTW, here's contact information for your neighborhood Community Planning Organization, if you have an interest in learning more about watching for such decisions. Also, here's the list of county advisory committee vacancies, and the application form.

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